期刊
ADVANCES IN THERAPY
卷 39, 期 11, 页码 4837-4846出版社
SPRINGER
DOI: 10.1007/s12325-022-02310-2
关键词
Heart failure; Preserved ejection fraction; Obstructive sleep apnea; SGLT2is; T2DM; NAFLD; Cardiorenal protection; Rehabilitation
In this mini-review, the complex interplay between heart failure, nonalcoholic fatty liver disease, and obstructive sleep apnea syndrome was examined. The study described the potential favorable effects of sodium-glucose cotransporter 2 inhibitors in heart failure with preserved ejection fraction through improved cardiorenal function and redistribution of body fat. These inhibitors may have promising roles in preventing, rehabilitating, and treating patients with obstructive sleep apnea, regardless of the presence of type 2 diabetes.
After examining the complex interplay between heart failure (HF) in its various clinical forms, metabolic disorders like nonalcoholic fatty liver disease (NAFLD), and obstructive sleep apnea (OSA) syndrome, in this mini-review we described possible favorable effects of sodium-glucose cotransporter 2 inhibitors (SGLT2is) on HF with preserved (i.e., >= 50%) ejection fraction (HFpEF) through enhanced cardiorenal function and visceral-subcutaneous body fat redistribution. In greater detail, on the basis of pathophysiological mechanisms underlying OSA onset and the direct positive SGLT2i effect on renal function benefiting chronic kidney disease, we emphasized the promising role of SGLT2is in prevention, rehabilitation, and treatment of patients with OSA regardless of coexisting type 2 diabetes (T2DM). Indeed, SGLT2is enhance lipolysis and fatty acid beta-oxidation. These phenomena might prevent OSA by reducing the size of visceral and subcutaneous adipose tissue and, as proven in humans and animals with T2DM, counteract NAFLD onset and progression. The aforementioned mechanisms may represent an additional SGLT2i cardioprotective effect in terms of HFpEF prevention in patients with OSA, whose NAFLD prevalence is estimated to be over 50%.
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