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SGLT2 Inhibitors and Ketone Metabolism in Heart Failure

Saucedo-Orozco Huitzilihuitl|Voorrips Suzanne N.|Yurista Salva R.|de Boer Rudolf A.|Westenbrink B. Daan
한국지질동맥경화학회 (The Korean Society of Lipidology and Atherosclerosis)|2022.01|지질·동맥경화학회지 (Journal of Lipid and Atherosclerosis)|제11권 제1호|pp. 1-19|DOI 10.12997/jla.2022.11.1.1

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참고문헌

키워드

InflammationSodium-glucose transporter 2 inhibitorsHeart failureKetone bodiesVentricular remodeling

초록

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as powerful drugs that can be used to treat heart failure (HF) patients, both with preserved and reduced ejection fraction and in the presence or absence of type 2 diabetes. While the mechanisms underlying the salutary effects of SGLT2 inhibitors have not been fully elucidated, there is clear evidence for a beneficial metabolic effect of these drugs. In this review, we discuss the effects of SGLT2 inhibitors on cardiac energy provision secondary to ketone bodies, pathological ventricular remodeling, and inflammation in patients with HF. While the specific contribution of ketone bodies to the pleiotropic cardiovascular benefits of SGLT2 inhibitors requires further clarification, ketone bodies themselves may also be used as a therapy for HF.

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as powerful drugs that can be used to treat heart failure (HF) patients, both with preserved and reduced ejection fraction and in the presence or absence of type 2 diabetes. While the mechanisms underlying the salutary effects of SGLT2 inhibitors have not been fully elucidated, there is clear evidence for a beneficial metabolic effect of these drugs. In this review, we discuss the effects of SGLT2 inhibitors on cardiac energy provision secondary to ketone bodies, pathological ventricular remodeling, and inflammation in patients with HF. While the specific contribution of ketone bodies to the pleiotropic cardiovascular benefits of SGLT2 inhibitors requires further clarification, ketone bodies themselves may also be used as a therapy for HF.

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