The role of sodium – glucose cotransporter-2 inhibitors in the treatment of different phenotypes of chronic heart failure

Abstract

The number of patients with chronic heart failure syndrome is steadily increasing worldwide and Ukraine is not an exception. About 50 % of patients with heart failure have preserved ejection fraction of left ventricle. Recently, there has been significant progress in the diagnosis of this phenotype of heart failure, many diagnostic scales and practice-oriented algorithms have been developed, but the issue of treatment of chronic heart failure remains open. Aim of the study. To summarize and analyze the results of large-scale randomized trials and to discuss the possible pathophysiological mechanisms underlying the “pleiotropiс” effects of sodium-glucose cotransporter-2 inhibitors. Sodium-glucose cotransporter-2 inhibitors are the first class of antidiabetic drugs that have demonstrated improved cardiovascular prognosis in patients with chronic heart failure with preserved ejection fraction regardless of the presence of diabetes mellitus. Conclusions. The necessity of prescribing sodium-glucose cotransporter-2 inhibitors in a cohort of patients with heart failure, regardless of left ventricular ejection fraction, has the highest level of evidence. The pathophysiological mechanisms underlying these effects are not fully understood. Further trials will allow us to identify new mechanisms of action and establish potential relationships between them.