Abstract

Recent studies have demonstrated benefits of sodium-glucose co-transporter 2 inhibitors (SGLT2i) in the management of heart failure with reduced ejection fraction (HFrEF). Although current literature postulates several salient effects, the primary mechanism is unclear. Intriguingly, benefit is seen rapidly. Improved myocardial energetics and substrate efficiency through Na+/H+ exchanger inhibition and increased β-hydroxybutyrate metabolism may rapidly reduce myocardial work.

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