Vascular and metabolic effects of SGLT2i and GLP-1 in heart failure patients

Alterations of endothelial function, inflammatory activation, and nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway are involved in the pathophysiology of heart failure. Metabolic alterations have been studied in the myocardium of heart failure (HF) patients; alterations in ketone body a...

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Bibliographic Details
Published in:Heart failure reviews 2023-05, Vol.28 (3), p.733-744
Main Authors: Correale, Michele, Lamacchia, Olga, Ciccarelli, Michele, Dattilo, Giuseppe, Tricarico, Lucia, Brunetti, Natale Daniele
Format: Article
Language:English
Subjects:
Amino acids
Cardiology
Cardiovascular Diseases
Cardiovascular System
Congestive heart failure
Cyclic GMP
Diabetes mellitus (non-insulin dependent)
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
GLP-1 receptor agonists
Glucagon
Glucagon-Like Peptide 1
Glucose transporter
Heart Failure
Humans
Inflammation
Medicine
Medicine & Public Health
Metabolism
Mitochondria
Myocardium
Nitric oxide
Protein turnover
Sodium-Glucose Transporter 2 Inhibitors - pharmacology
Sodium-Glucose Transporter 2 Inhibitors - therapeutic use
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Summary:Alterations of endothelial function, inflammatory activation, and nitric oxide-cyclic guanosine monophosphate (NO-cGMP) pathway are involved in the pathophysiology of heart failure. Metabolic alterations have been studied in the myocardium of heart failure (HF) patients; alterations in ketone body and amino acid/protein metabolism have been described in patients affected by HF, as well as mitochondrial dysfunction and other modified metabolic signaling. However, their possible contributions toward cardiac function impairment in HF patients are not completely known. Recently, sodium-glucose co-transporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) have emerged as a new class of drugs designed to treat patients with type 2 diabetes (T2D), but have also been shown to be protective against HF-related events and CV mortality. To date, the protective cardiovascular effects of these drugs in patients with and without T2D are not completely understood and several mechanisms have been proposed. In this review, we discuss on vascular and metabolic effects of SGLT2i and GLP-1 in HF patients.
ISSN:1573-7322
1382-4147
1573-7322
DOI:10.1007/s10741-021-10157-y