Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors

The findings of large-scale cardiovascular outcome trials have been demonstrated that sodium-glucose cotransporter 2 ­inhibitors (iSGLT-2) have shown beneficial cardiovascular effects. In this review proposed mechanisms underlying iSGLT-2-associated cardiovascular benefits have been discussed: haemo...

Full description

Saved in:
Bibliographic Details
Main Authors: A. M. Mkrtumyan, T. N. Markova, N. K. Mishchenko
Format: Article
Language:English
Published: Endocrinology Research Centre 2021-09-01
Series:Сахарный диабет
Subjects:
Online Access:https://www.dia-endojournals.ru/jour/article/view/12541
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849729821434707968
author A. M. Mkrtumyan
T. N. Markova
N. K. Mishchenko
author_facet A. M. Mkrtumyan
T. N. Markova
N. K. Mishchenko
author_sort A. M. Mkrtumyan
collection DOAJ
description The findings of large-scale cardiovascular outcome trials have been demonstrated that sodium-glucose cotransporter 2 ­inhibitors (iSGLT-2) have shown beneficial cardiovascular effects. In this review proposed mechanisms underlying iSGLT-2-associated cardiovascular benefits have been discussed: haemodynamic and intracellular effects, including metabolic effects and electrolyte changes; and also, the effect on markers of cardiovascular disease (CVD). The hemodynamic effects of SGLT-2 are characterized by reduction of cardiac preload and afterload as a result of osmotic diuresis, a decrease in blood pressure and arterial stiffness. The metabolic effects of this medicine are accompanied by an increase the production of ketone bodies, followed by improving ATP production and myocardial energetics. Also, iSGLT-2 modulate ion transporters (NHE1 and NHE3). A reduction of cytoplasmic sodium and calcium levels and increasing mitochondrial calcium levels in the cardiomyocytes enhances the synthesis of ATP and increases cell viability. Effect of iSGLT-2 on CVD markers showed a decrease in the levels of the N-terminal pro-B-type natriuretic peptide and highly sensitive troponin I in elderly patients with type 2 diabetes mellitus (T2DM). Thus, this class of agents has a multifactorial effect on the functioning of cardiovascular system. Further studies will help to explain the all possible cardioprotective effects of iSGLT-2 in individuals with and without T2DM.
format Article
id doaj-art-97d2e8917f464f4da6b7cc5a343337ff
institution DOAJ
issn 2072-0351
2072-0378
language English
publishDate 2021-09-01
publisher Endocrinology Research Centre
record_format Article
series Сахарный диабет
spelling doaj-art-97d2e8917f464f4da6b7cc5a343337ff2025-08-20T03:09:04ZengEndocrinology Research CentreСахарный диабет2072-03512072-03782021-09-0124329129910.14341/DM1254110881Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitorsA. M. Mkrtumyan0T. N. Markova1N. K. Mishchenko2Moscow State University of Medicine and Dentistry named after A.I. EvdokimovMoscow State University of Medicine and Dentistry named after A.I. Evdokimov; City Clinical Hospital №52Moscow State University of Medicine and Dentistry named after A.I. EvdokimovThe findings of large-scale cardiovascular outcome trials have been demonstrated that sodium-glucose cotransporter 2 ­inhibitors (iSGLT-2) have shown beneficial cardiovascular effects. In this review proposed mechanisms underlying iSGLT-2-associated cardiovascular benefits have been discussed: haemodynamic and intracellular effects, including metabolic effects and electrolyte changes; and also, the effect on markers of cardiovascular disease (CVD). The hemodynamic effects of SGLT-2 are characterized by reduction of cardiac preload and afterload as a result of osmotic diuresis, a decrease in blood pressure and arterial stiffness. The metabolic effects of this medicine are accompanied by an increase the production of ketone bodies, followed by improving ATP production and myocardial energetics. Also, iSGLT-2 modulate ion transporters (NHE1 and NHE3). A reduction of cytoplasmic sodium and calcium levels and increasing mitochondrial calcium levels in the cardiomyocytes enhances the synthesis of ATP and increases cell viability. Effect of iSGLT-2 on CVD markers showed a decrease in the levels of the N-terminal pro-B-type natriuretic peptide and highly sensitive troponin I in elderly patients with type 2 diabetes mellitus (T2DM). Thus, this class of agents has a multifactorial effect on the functioning of cardiovascular system. Further studies will help to explain the all possible cardioprotective effects of iSGLT-2 in individuals with and without T2DM.https://www.dia-endojournals.ru/jour/article/view/12541sodium-glucose cotransporter 2 inhibitorscardiovascular effectsketogenesissodium/hydrogen exchangern-terminal pro-b-type natriuretic peptidehigh-sensitivity troponin i
spellingShingle A. M. Mkrtumyan
T. N. Markova
N. K. Mishchenko
Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors
Сахарный диабет
sodium-glucose cotransporter 2 inhibitors
cardiovascular effects
ketogenesis
sodium/hydrogen exchanger
n-terminal pro-b-type natriuretic peptide
high-sensitivity troponin i
title Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors
title_full Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors
title_fullStr Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors
title_full_unstemmed Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors
title_short Cardioprotective mechanisms of sodium-glucose cotransporter 2 inhibitors
title_sort cardioprotective mechanisms of sodium glucose cotransporter 2 inhibitors
topic sodium-glucose cotransporter 2 inhibitors
cardiovascular effects
ketogenesis
sodium/hydrogen exchanger
n-terminal pro-b-type natriuretic peptide
high-sensitivity troponin i
url https://www.dia-endojournals.ru/jour/article/view/12541
work_keys_str_mv AT ammkrtumyan cardioprotectivemechanismsofsodiumglucosecotransporter2inhibitors
AT tnmarkova cardioprotectivemechanismsofsodiumglucosecotransporter2inhibitors
AT nkmishchenko cardioprotectivemechanismsofsodiumglucosecotransporter2inhibitors