Potential mechanisms of reduced heart failure hospitalization with SGLT2 inhibitors
Four main potential reasons for protection against heart failure (HF) hospitalization by SGLT2 inhibitors:
- Contraction of plasma volume and reduction of blood pressure reducing preload and afterload.
- Increased ketone production can be used for the production of ATP by the myocardium more efficiently.
- Inhibition of sodium-hydrogen exchange in myocardial cells can lead to reduction of hypertrophy, systolic dysfunction, fibrosis and remodeling.
- Reduced arrhythmic risk possibily due to suppression of sympathetic nervous system leading to lower sudden cardiac death.
- Cherney DZ, Odutayo A, Aronson R, Ezekowitz J, Parker JD. Sodium Glucose Cotransporter-2 Inhibition and Cardiorenal Protection: JACC Review Topic of the Week. J Am Coll Cardiol. 2019 Nov 19;74(20):2511-2524.