Beyond the myocardium? SGLT2 inhibitors target peripheral components of reduced oxygen flux in the diabetic patient with heart failure with preserved ejection fraction

Nashawi, Mouhamed; Sheikh, Omar; Battisha, Ayman; Mir, Mahnoor; Chilton, Robert

doi:10.1007/s10741-020-09996-y

Cited by 3 publications

(1 citation statement)

References 146 publications

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“…The induction of TNF-α from sarcopenic obesity inhibits adiponectin while negatively impacting myocyte mitochondrial biogenesis and myogenesis, causing a vicious cycle within sarcopenia obesity of decreased muscle mass and increased adiposity [64]. Overexpression of TNF-α from sarcopenic obesity also downregulates eNOS, further exacerbating hemodynamics, while promoting a negative ionotropic cardiac state [65,66]. Moreover, there is evidence to show that it promotes pathologic vascular and valvular calcification [67,68].…”

Section: The Sarcopenic Obesity Phenotype and Testosteronementioning

confidence: 99%

Cardiovascular Health, Testosterone, and Oxandrolone: Leveraging the Myotrophic-Androgenic Ratio in Males with a Sarcopenic Obese Phenotype

Nashawi¹,

Ms²,

Ahmad³

et al. 2021

austinjpharmacolther

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Anabolic-Androgenic Steroids (AAS) are a group of organic compounds that include testosterone, or related compounds that induce similar effects by serving as structural analogues. Because of their propensity to induce gene expression that promotes protein synthesis, increased lean body mass, and strength, they have found utility in medicine to aide patients with chronic wasting syndromes, deficiencies in growth stature, and trauma recovery (e.g., burns). Contemporary off-label use of these classes of agents are also being used in anti-aging capacities under clinical supervision, and those with cardiovascular deficits related to metabolic derangement. Nevertheless, as hormones, testosterone and its analogues have systemic effects and their glut can be deleterious to global organs, namely the heart. Chronic utilization of these agents can be seen in domains of competitive physical activities given their performance enhancing effects. Associated with this abuse in particular have been ubiquitous clinical accounts of Major Adverse Cardiovascular Events (MACE), chronic hypertension, dyslipidemia, and left ventricular remodeling given the pleiotropic effects of testosterone and its analogues. One agent in particular, oxandrolone, a synthetic AAS, has an interesting profile as it has a biological disposition to more anabolic and metabolic effects compared to other AAS, with less profuse androgenic properties. There has been evidence to show that even oxandrolone supplementation may show promise in improving peripheral homeostasis conducive to positive cardiovascular health, especially in obese patients with features of metabolic syndrome, a condition related to endocrinological dysfunction and aberrant adiposity. In this commentary we will review the effects of this AAS with a commentary on cardiovascular physiology constructed around translational biology and clinical data. Commentaries such as the latter are scant in the literature and offer perspectives crucial to understanding the intersections between habitus, physiologic status, and the heart. Overall, oxandrolone shows promise related to its pharmacology in patients with low muscle tone and significant adiposity, namely cardiometabolic profiles if administered with clinical prudence due to its novel structure, metabolism, and effects.

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Section: The Sarcopenic Obesity Phenotype and Testosteronementioning

confidence: 99%

Cardiovascular Health, Testosterone, and Oxandrolone: Leveraging the Myotrophic-Androgenic Ratio in Males with a Sarcopenic Obese Phenotype

Nashawi¹,

Ms²,

Ahmad³

et al. 2021

austinjpharmacolther

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Novel cardioprotective mechanism for Empagliflozin in nondiabetic myocardial infarction with acute hyperglycemia

Deng

Jiang

Chen

et al. 2022

Biomedicine & Pharmacotherapy

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Empagliflozin—A New Chance for Patients with Chronic Heart Failure

et al. 2021

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The heart failure (HF) epidemic is one of the challenges that has been faced by the healthcare system worldwide for almost 25 years. With an ageing world population and a fast-paced lifestyle that promotes the development of cardiovascular disease, the number of people suffering from heart failure will continue to rise. To improve the treatment regimen and consequently the prognosis and quality of life of heart failure patients, new therapeutic solutions have been introduced, such as an inclusion of Sodium-glucose co-transporter 2 (SGLT-2) inhibitors in a new treatment regimen as announced by the European Society of Cardiology in August 2021. This article focuses on the SGLT2 inhibitor empagliflozin and its use in patients with heart failure. Empagliflozin is a drug originally intended for the treatment of diabetes due to its glycosuric properties, yet its beneficial effects extend beyond lowering glycemia. The pleiotropic effects of the drug include nephroprotection, improving endothelial function, lowering blood pressure and reducing body weight. In this review we discuss the cardioprotective mechanism of the drug in the context of the benefits of empagliflozin use in patients with chronic cardiac insufficiency. Numerous findings confirm that despite its potential limitations, the use of empagliflozin in HF treatment is advantageous and effective.

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Beyond the myocardium? SGLT2 inhibitors target peripheral components of reduced oxygen flux in the diabetic patient with heart failure with preserved ejection fraction

Cited by 3 publications

References 146 publications

Cardiovascular Health, Testosterone, and Oxandrolone: Leveraging the Myotrophic-Androgenic Ratio in Males with a Sarcopenic Obese Phenotype

Cardiovascular Health, Testosterone, and Oxandrolone: Leveraging the Myotrophic-Androgenic Ratio in Males with a Sarcopenic Obese Phenotype

Novel cardioprotective mechanism for Empagliflozin in nondiabetic myocardial infarction with acute hyperglycemia

Empagliflozin—A New Chance for Patients with Chronic Heart Failure

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