Proposed mechanisms of systemic cardiovascular action of gliflosins

Abstract

The literature review is devoted to the study of the mechanisms of the cardioprotective action of a new class of glucose-lowering drugs glyflozins, which inhibit the joint transport of sodium and glucose in the proximal renal tubules. The large-scale clinical trials carried out in recent years have demonstrated the beneficial effect of these compounds not only on glycemic control, but also on the progression of heart failure in patients with diabetes mellitus. Analysis of literature data shows that the effect under consideration is due to both the positive systemic cardiovascular and direct cardiotropic action of the drugs. The first part of the review examines the systemic effect of drugs, including their diuretic, natriuretic and antihypertensive effects, increased hematocrit, vascular effects that influence arterial stiffness, smooth muscle tone, and endothelial dysfunction. The metabolic effects of type 2 sodium and glucose co-transport inhibitors are discussed separately, including an increase in lipolysis, the role of glucagon and activation of ketogenesis, and their contribution to the development of a probable cardioprotective effect.