[1]高棣英 吴铿.SGLT2抑制剂对射血分数保留的心力衰竭的保护作用及机制研究进展[J].心血管病学进展,2024,(3):224.[doi:10.16806/j.cnki.issn.1004-3934.2024.03.008]
 GAO Diying,WU Keng.Protective Effect and Mechanism of SGLT2 Inhibitor on Heart Failure with Preserved Ejection Fraction[J].Advances in Cardiovascular Diseases,2024,(3):224.[doi:10.16806/j.cnki.issn.1004-3934.2024.03.008]
点击复制

SGLT2抑制剂对射血分数保留的心力衰竭的保护作用及机制研究进展()
分享到:

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2024年3期
页码:
224
栏目:
综述
出版日期:
2024-03-25

文章信息/Info

Title:
Protective Effect and Mechanism of SGLT2 Inhibitor on Heart Failure with Preserved Ejection Fraction
作者:
高棣英 吴铿
(广东医科大学附属医院,广东 湛江 524001)
Author(s):
GAO DiyingWU Keng
(The Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,Guangdong,China)
关键词:
心力衰竭射血分数保留的心力衰竭钠-葡萄糖共转运蛋白2抑制剂
Keywords:
Heart failureHeart failure with preserved ejection fractionSodium-glucose co-transporter 2 inhibitor
DOI:
10.16806/j.cnki.issn.1004-3934.2024.03.008
摘要:
心力衰竭(心衰)是心血管疾病发展的终末阶段和主要死因,其患病率、再住院率、病死率均高,防治难度极大。其中射血分数保留的心力衰竭(HFpEF)是心衰的主要类型,目前约占心衰总患病人数的50%,在65岁以上人群中超过70%。随着新型抗心衰药物的出现,射血分数降低的心力衰竭患者的再住院率和死亡率逐渐降低,但HFpEF仍面临治疗困境。据报道,钠-葡萄糖共转运蛋白2抑制剂可独立作用于心脏,并通过多种机制治疗心衰患者,但其提供临床益处的生物学机制尚未完全阐明。
Abstract:
Heart failure is the terminal stage and the main cause of death in the development of cardiovascular disease,with a high prevalence rate,rehospitalization rate and mortality rate,making the prevention and treatment extremely difficult. Among them,heart failure with preserved ejection fraction(HFpEF) is the main type of heart failure,accounting for about 50% of the total number of heart failure,and more than 70% of people over 65 years old. With the emergence of new anti-heart failure drugs,the patients’ rehospitalization rate and mortality rate of heart failure with reduced ejection fraction have gradually decreased,but HFpEF still faces a treatment dilemma. It has been reported that sodium-glucose co-transporter 2 inhibitors act independently on the heart,and treat heart failure patients through multiple mechanisms,but the biological mechanisms that provide clinical benefits have not been fully elucidated

参考文献/References:

[1] In China TWCOTROCHAD,Hu SS. Report on cardiovascular health and diseases in China 2021:an updated summary [J]. J Geriatr Cardiol,2023,20(6):399-430.

[2] Cai A,Qiu W,Zhou Y,et al. Clinical characteristics and 1-year outcomes in hospitalized patients with heart failure with preserved ejection fraction:results from the China Cardiovascular Association Database-Heart Failure Center Registry[J]. Eur J Heart Fail,2022,24(11):2048-2062.

[3] Savarese G,Stolfo D,Sinagra G,et al. Heart failure with mid-range or mildly reduced ejection fraction[J]. Nat Rev Cardiol,2022,19(2):100-116.

[4] Dewan P,Solomon SD,Jhund PS,et al. Efficacy and safety of sodium-glucose co-transporter 2 inhibition according to left ventricular ejection fraction in DAPA-HF [J]. Eur J Heart Fail,2020,22(7):1247-1258.

[5] Solomon SD,Vaduganathan M,Claggett BL,et al. Baseline characteristics of patients with HF with mildly reduced and preserved ejection fraction:DELIVER trial[J]. JACC Heart Fail,2022,10(3):184-197.

[6] Ismayl M,Abbasi MA,Al-Abcha A,et al. Sodium-glucose cotransporter-2 inhibitors in heart failure with mildly reduced or preserved ejection fraction:a systematic review and meta-analysis of randomized controlled trials[J]. Curr Probl Cardiol,2023,48(5):101597.

[7] Cao H,Rao X,Jia J,et al. Effects of sodium-glucose co-transporter-2 inhibitors on kidney,cardiovascular,and safety outcomes in patients with advanced chronic kidney disease:a systematic review and meta-analysis of randomized controlled trials[J]. Acta Diabetol,2023,60(3):325-335.

[8] Wheeler DC,Stefánsson BV,Jongs N,et al. Effects of dapagliflozin on major adverse kidney and cardiovascular events in patients with diabetic and non-diabetic chronic kidney disease:a prespecified analysis from the DAPA-CKD trial[J]. Lancet Diabetes Endocrinol,2021,9(1):22-31.

[9] DeFronzo RA,Reeves WB,Awad AS. Pathophysiology of diabetic kidney disease:impact of SGLT2 inhibitors[J]. Nat Rev Nephrol,2021,17(5):319-334.

[10] 周京敏,王华,黎励文. 射血分数保留的心力衰竭诊断与治疗中国专家共识2023 [J]. 中国循环杂志,2023,38(4):375-393.

[11] Griffin M,Rao VS,Ivey-Miranda J,et al. Empagliflozin in heart failure:diuretic and cardiorenal effects[J]. Circulation,2020,142(11):1028-1039.

[12] Shiina K,Tomiyama H,Tanaka A,et al. Canagliflozin independently reduced plasma volume from conventional diuretics in patients with type 2 diabetes and chronic heart failure:a subanalysis of the CANDLE trial[J]. Hypertens Res,2023,46(2):495-506.

[13] Sakai T,Miura S. Effects of sodium-glucose cotransporter 2 inhibitor on vascular endothelial and diastolic function in heart failure with preserved ejection fraction—Novel prospective cohort study[J]. Circ Rep,2019,1(7):286-295.

[14] Shim CY,Seo J,Cho I,et al. Randomized,controlled trial to evaluate the effect of dapagliflozin on left ventricular diastolic function in patients with type 2 diabetes mellitus:the IDDIA trial[J]. Circulation,2021,143(5):510-512.

[15] Connelly KA,Zhang Y,Visram A,et al. Empagliflozin improves diastolic function in a nondiabetic rodent model of heart failure with preserved ejection fraction[J]. JACC Basic Transl Sci,2019,4(1):27-37.

[16] Moellmann J,Klinkhammer BM,Droste P,et al. Empagliflozin improves left ventricular diastolic function of db/db mice[J]. Biochim Biophys Acta Mol Basis Dis,2020,1866(8):165807.

[17] Sanders-van Wijk S,van Empel V,Davarzani N,et al. Circulating biomarkers of distinct pathophysiological pathways in heart failure with preserved vs. reduced left ventricular ejection fraction[J]. Eur J Heart Fail,2015,17(10):1006-1014.

[18] Kolijn D,Pabel S,Tian Y,et al. Empagliflozin improves endothelial and cardiomyocyte function in human heart failure with preserved ejection fraction via reduced pro-inflammatory-oxidative pathways and protein kinase Gα oxidation [J]. Cardiovasc Res,2021,117(2):495-507.

[19] Kondo H,Akoumianakis I,Badi I,et al. Effects of canagliflozin on human myocardial redox signalling:clinical implications[J]. Eur Heart J,2021,42(48):4947-4960.

[20] Takahara S,Soni S,Maayah ZH,et al. Ketone therapy for heart failure:current evidence for clinical use[J]. Cardiovasc Res,2022,118(4):977-987.

[21] Santos-Gallego CG,Requena-Ibanez JA,San Antonio R,et al. Empagliflozin ameliorates adverse left ventricular remodeling in nondiabetic heart failure by enhancing myocardial energetics[J]. J Am Coll Cardiol,2019,73(15):1931-1944.

[22] Li X,Lu Q,Qiu Y,et al. Direct cardiac actions of the sodium glucose co-transporter 2 inhibitor empagliflozin improve myocardial oxidative phosphorylation and attenuate pressure-overload heart failure[J]. J Am Heart Assoc,2021,10(6):e018298.

[23] 刘海浪,张立,胡婷婷,等. 达格列净保护缺血性心力衰竭大鼠心脏的微小RNA表达谱系研究 [J]. 中国心血管杂志,2021,26(5):477-482.

[24] Triposkiadis F,Xanthopoulos A,Starling RC,et al. Obesity,inflammation,and heart failure:links and misconceptions[J]. Heart Fail Rev,2022,27(2):407-418.

[25] Lee TM,Chang NC,Lin SZ. Dapagliflozin,a selective SGLT2 inhibitor,attenuated cardiac fibrosis by regulating the macrophage polarization via STAT3 signaling in infarcted rat hearts[J]. Free Radic Biol Med,2017,104:298-310.

[26] Abdollahi E,Keyhanfar F,Delbandi AA,et al. Dapagliflozin exerts anti-inflammatory effects via inhibition of LPS-induced TLR-4 overexpression and NF-κB activation in human endothelial cells and differentiated macrophages[J]. Eur J Pharmacol,2022,918:174715.

[27] Kang S,Verma S,Hassanabad AF,et al. Direct effects of empagliflozin on extracellular matrix remodelling in human cardiac myofibroblasts:novel translational clues to explain EMPA-REG OUTCOME results[J]. Can J Cardiol,2020,36(4):543-553.

[28] Lee HC,Shiou YL,Jhuo SJ,et al. The sodium-glucose co-transporter 2 inhibitor empagliflozin attenuates cardiac fibrosis and improves ventricular hemodynamics in hypertensive heart failure rats[J]. Cardiovasc Diabetol,2019,18(1):45.

[29] Varadhan A,Stephan K,Gupta R,et al. Growing role of SGLT2i in heart failure:evidence from clinical trials[J]. Expert Rev Clin Pharmacol,2022,15(2):147-159.

[30] Mazer CD,Hare GMT,Connelly PW,et al. Effect of empagliflozin on erythropoietin levels,iron stores,and red blood cell morphology in patients with type 2 diabetes mellitus and coronary artery disease[J]. Circulation,2020,141(8):704-707.

[31] Ghanim H,Abuaysheh S,Hejna J,et al. Dapagliflozin suppresses hepcidin and increases erythropoiesis[J]. J Clin Endocrinol Metab,2020,105(4):dgaa057.

[32] Fuchs Andersen C,Omar M,Glenth?j A,et al.Effects of empagliflozin on erythropoiesis in heart failure:data from the Empire HF trial[J]. Eur J Heart Fail,2023,25(2):226-234.

[33] Nalliah CJ,Bell JR,Raaijmakers AJA,et al. Epicardial adipose tissue accumulation confers atrial conduction abnormality[J]. J Am Coll Cardiol,2020,76(10):1197-1211.

[34] van Woerden G,van Veldhuisen DJ,Manintveld OC,et al. Epicardial adipose tissue and outcome in heart failure with mid-range and preserved ejection fraction[J]. Circ Heart Fail,2022,15(3):e009238.

[35] Rossi VA,Gruebler M,Monzo L,et al. The different pathways of epicardial adipose tissue across the heart failure phenotypes:from pathophysiology to therapeutic target[J]. Int J Mol Sci,2023,24(7):6838.

[36] Sato T,Aizawa Y,Yuasa S,et al. The effect of dapagliflozin treatment on epicardial adipose tissue volume and P-wave indices:an ad-hoc analysis of the previous randomized clinical trial[J]. J Atheroscler Thromb,2020,27(12):1348-1358.

[37] Myasoedova VA,Parisi V,Moschetta D,et al. Efficacy of cardiometabolic drugs in reduction of epicardial adipose tissue:a systematic review and meta-analysis[J]. Cardiovasc Diabetol,2023,22(1):23.

[38] Mullens W,Martens P. Empagliflozin-induced changes in epicardial fat:the centerpiece for myocardial protection?[J]. JACC Heart Fail,2021 ,9(8):590-593.

相似文献/References:

[1]丁娟,刘地川.心力衰竭与线粒体功能障碍的研究进展[J].心血管病学进展,2016,(1):84.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.022]
 DING Juan,LIU Dichuan.Research Progress of Heart Failure and Mitochondrial Dysfunction[J].Advances in Cardiovascular Diseases,2016,(3):84.[doi:10.16806/j.cnki.issn.1004-3934.2016.01.022]
[2]罗秀林,综述,张烁,等.肾动脉去交感神经术治疗心力衰竭——希望还是炒作[J].心血管病学进展,2016,(3):268.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.013]
 LUO Xiulin,ZHANG Shuo.Renal Sympathetic Denervation for Heart Failure—Hopes or Hypes[J].Advances in Cardiovascular Diseases,2016,(3):268.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.013]
[3]查凤艳,综述,覃数,等.心源性恶病质发病机制的研究进展[J].心血管病学进展,2016,(3):282.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.017]
 ZHA Fengyan,QIN Shu.Advances in Pathogenesis of Cardiac Cachexia[J].Advances in Cardiovascular Diseases,2016,(3):282.[doi:10.16806/j.cnki.issn.1004-3934.2016.03.017]
[4]李慧,综述,齐国先,等.老年射血分数保留的心功能不全研究进展[J].心血管病学进展,2016,(4):354.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.007]
 LI Hui,QI Guoxian.Research Progress of Heart Failure with Preserved Ejection Fraction in Elderly People[J].Advances in Cardiovascular Diseases,2016,(3):354.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.007]
[5]亢玉,综述,张庆,等.二尖瓣瓣叶在功能性二尖瓣反流发生机制中的角色[J].心血管病学进展,2016,(4):376.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.013]
 KANG Yu,ZHANG Qing.Role of Mitral Leaflets in Pathogenesis of Functional Mitral Regurgitation[J].Advances in Cardiovascular Diseases,2016,(3):376.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.013]
[6]史秀莉,张庆,喻鹏铭.心力衰竭患者运动训练方式及其疗效的研究进展[J].心血管病学进展,2015,(5):535.[doi:10.3969/j.issn.1004-3934.2015.05.003]
 SHI Xiuli,ZHANG Qing,YU Pengming.Exercise Training Modalities and Their Treatment Effects on Patients with Heart Failure[J].Advances in Cardiovascular Diseases,2015,(3):535.[doi:10.3969/j.issn.1004-3934.2015.05.003]
[7]熊卓超,陈康玉,严激.无创血流动力学评价在心力衰竭中的应用进展[J].心血管病学进展,2019,(6):923.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.021]
 XIONG Zhuochao,CHEN Kangyu,YAN Ji.Application Progress of Noninvasive Hemodynamic Evaluation in Heart Failure[J].Advances in Cardiovascular Diseases,2019,(3):923.[doi:10.16806/j.cnki.issn.1004-3934.2019.06.021]
[8]高薇 陈伟.铁过载性心肌病[J].心血管病学进展,2019,(5):680.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.006]
 GAO WeiCHEN Wei.Iron Overload Cardiomyopathy[J].Advances in Cardiovascular Diseases,2019,(3):680.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.006]
[9]何燕 刘育.C型利钠肽与心力衰竭[J].心血管病学进展,2019,(5):745.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.020]
 HE Yan,LIU Yu.C-type Natriuretic Peptide and Heart Failure[J].Advances in Cardiovascular Diseases,2019,(3):745.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.020]
[10]唐欣 罗素新.心房颤动合并 射血分数保留的心力衰竭的研究进展[J].心血管病学进展,2019,(5):753.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.022]
 TANG Xin,LUO Suxin.Atrial Fibrillation and Heart Failure with Preserved Ejection Fraction[J].Advances in Cardiovascular Diseases,2019,(3):753.[doi:10.16806/j.cnki.issn.1004-3934.2019.05.022]

更新日期/Last Update: 2024-04-26