Cited by 999Diabetes Treatment and ManagementHeart Failure Treatment and ManagementCardiovascular Function and Risk Factors

SGLT2 inhibitors and mechanisms of cardiovascular benefit: a state-of-the-art review

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Verma, Subodh, McMurray, John J. V.·2018·Diabetologia

Abstract

Sodium-glucose cotransporter (SGLT)2 inhibitors have been demonstrated to reduce cardiovascular events, particularly heart failure, in cardiovascular outcome trials. Here, we review the proposed mechanistic underpinnings of this benefit. Specifically, we focus on the role of SGLT2 inhibitors in optimising ventricular loading conditions through their effect on diuresis and natriuresis, in addition to reducing afterload and improving vascular structure and function. Further insights into the role of SGLT2 inhibition in myocardial metabolism and substrate utilisation are outlined. Finally, we discuss two emerging themes: how SGLT2 inhibitors may regulate Na+/H+ exchange at the level of the heart and kidney and how they may modulate adipokine production. The mechanistic discussion is placed in the context of completed and ongoing trials of SGLT2 inhibitors in the prevention and treatment of heart failure in individuals with and without diabetes.

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Authors
Verma, S., & McMurray, J. J. V.
Affiliations
  • St. Michael's Hospital (CA)
  • University of Glasgow (GB)
Corresponding author
Verma, Subodh
Venue
Diabetologia
Published
2018-08-22
Volume
61
Issue
10
Pages
2108-2117
ISSN
  • 0012-186X (ISSN-L)
  • 1432-0428
OpenAlex
W2884466498
Cited by
999
References
67
Citations by year
2026: 112 · 2025: 104 · 2024: 109 · 2023: 115 · 2022: 150 · 2021: 172 · 2020: 132 · 2019: 93 · 2018: 9
FWCI
15.65
Type
journal article
Language
en
Open access
Locations
  • Diabetologia (publishedVersion)
  • PubMed (publishedVersion)
  • Research Bank (Australian Catholic University) (submittedVersion)
  • ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion, cc-by-sa)
Funders
  • Amgen
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • Sanofi
  • Valeant Pharmaceuticals International
  • University of Glasgow
  • Novo Nordisk
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
SGLT2 inhibitors, heart failure, cardiovascular benefits, diuresis, sodium excretion, afterload, vascular function, myocardial metabolism, substrate utilization, Na+/H+ exchange, adipokines, diabetes mellitus, ventricular loading
MeSH terms
Sodium-Glucose Transporter 2 Inhibitors, Animals, Benzhydryl Compounds, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Glucosides, Heart, Heart Ventricles, Humans, Hypoglycemic Agents, Kidney, Diabetes Complications, Adipokines

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