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...
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Endocrinology Research Centre
2021-09-01
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| Series: | Сахарный диабет |
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| Online Access: | https://www.dia-endojournals.ru/jour/article/view/12541 |
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| 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 |