Current and future therapeutic perspective in chronic heart failure

Mascolo, Annamaria; Mauro, Gabriella di; Cappetta, Donato; Angelis, Antonella De; Torella, Daniele; Urbanek, Konrad; Berrino, Liberato; Nicoletti, Giovanni Francesco; Capuano, Annalisa; Rossi, Francesco

doi:10.1016/j.phrs.2021.106035

Cited by 45 publications

(37 citation statements)

References 95 publications

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“…Moreover, SGLT2 inhibitors do not increase the neurohormonal activation (RAAS and sympathetic pathways), leading to a positive left ventricular remodeling ( 49 , 50 ) and highlighting a positive pharmacodynamic interaction between SGLT2 inhibitors and RAAS inhibitors ( 38 ). SGLT2 inhibitors can also directly target cardiomyocytes and endothelial cells by interacting with other channels and transporters present on cell surface, including the SGLT1, NHE1 and Nav1.5 ( 5 ). Another pleiotropic effect with a cardiac benefit is the reduction of NT-proBNP caused by SGLT2 inhibitors, which correlates with a reduction in ventricular pressure and distention, preload and both pulmonary and systemic congestion ( 5 ).…”

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

“…SGLT2 inhibitors can also directly target cardiomyocytes and endothelial cells by interacting with other channels and transporters present on cell surface, including the SGLT1, NHE1 and Nav1.5 ( 5 ). Another pleiotropic effect with a cardiac benefit is the reduction of NT-proBNP caused by SGLT2 inhibitors, which correlates with a reduction in ventricular pressure and distention, preload and both pulmonary and systemic congestion ( 5 ). Finally, SGLT2 inhibitors shift the fuel energetics of myocardium toward ketones, thus improving the myocardial work efficiency ( 37 ).…”

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

“…Finally, SGLT2 inhibitors shift the fuel energetics of myocardium toward ketones, thus improving the myocardial work efficiency ( 37 ). Moreover, based on the results of two clinical trials (DAPA-HF and EMPEROR-Reduced), SGLT2 inhibitors are now recommended for the treatment of heart failure with reduced ejection fraction in association with standard treatments regardless of the presence of diabetes mellitus ( 5 ). Finally, based on the results from the EMPEROR-preserved trial, empagliflozin is also recommended in patients with a preserved ejection fraction ( 5 ).…”

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

“…Moreover, based on the results of two clinical trials (DAPA-HF and EMPEROR-Reduced), SGLT2 inhibitors are now recommended for the treatment of heart failure with reduced ejection fraction in association with standard treatments regardless of the presence of diabetes mellitus ( 5 ). Finally, based on the results from the EMPEROR-preserved trial, empagliflozin is also recommended in patients with a preserved ejection fraction ( 5 ). Benefit effects are also shown in patients with type 2 diabetes mellitus hospitalized for acute myocardial infarction and treated with SGLT2-inhibitors.…”

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

“…Type 2 diabetes mellitus is a cardio-renal-metabolic condition, sometimes associated with other diseases, such as heart failure and atherosclerotic cardiovascular disease (ASCVD) ( 4 ). This pharmacological class was also associated with a consistent improvement of cardiovascular outcomes in patients with type 2 diabetes mellitus with concomitant cardiovascular or chronic kidney disease, and in patients with heart failure ( 5 ). However, despite their clinical advantages, SGLT2 inhibitors have also been associated with the occurrence of adverse events.…”

Section: Introductionmentioning

confidence: 95%

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Safety profile of sodium glucose co-transporter 2 (SGLT2) inhibitors: A brief summary

Mascolo

Napoli

Balzano

et al. 2022

Front. Cardiovasc. Med.

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A new therapeutic class of oral agents firstly used for the treatment of type 2 diabetes mellitus is represented by gliflozines or sodium-glucose co-transporter 2 (SGLT2) inhibitors. SGLT2 inhibitors might be effective alone or in combination with any other drugs. This therapeutic class currently includes five agents: canagliflozin, dapagliflozin, empagliflozin, ertugliflozin, and sotagliflozin. SGLT2 inhibitors prevent the renal reabsorption of filtered glucose and sodium by blocking the SGLT2 co-transporters in the proximal convoluted renal tubule, facilitating glucose excretion in the urine (glycosuria) and lowering blood glucose levels. SGLT2 inhibitors have also shown to have pleiotropic effects and determine cardiovascular and renal prevention, thus leading to an extension of their therapeutic indication to include the heart failure. Despite their clinical benefits, warnings about adverse events have been implemented by Regulatory Agencies in the product's information since their introduction to the market. In particular, SGLT2 inhibitors have shown a strong impact on a high number of risk factors. They can cause hypoglycaemia, hypotension, lower limb amputation, fractures, genito-urinary infections, and diabetic ketoacidosis with different frequencies of onset. Despite some of these events are rare, they can lead to serious and dangerous complications, highlighting the importance of a strict monitoring of patients. Overall, SLGT-2 inhibitors are effective antidiabetic drugs with favorable advantages in renal and cardiovascular protection, and with a generally well-tolerated safety profile. This review aims to summarize the safety profile of SGLT2 inhibitors available in the market.

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Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

Section: Safety Of Sglt2 Inhibitorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 3 more Smart Citations

Safety profile of sodium glucose co-transporter 2 (SGLT2) inhibitors: A brief summary

Mascolo

Napoli

Balzano

et al. 2022

Front. Cardiovasc. Med.

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New approach to heart failure: Integrated traditional Chinese with Western medicine

Wang,

Cao,

et al. 2024

Advanced Chinese Medicine

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Heart failure (HF) is a major global healthcare problem leading to substantial deterioration of prognosis. The current clinical guidelines in HF have begun to emphasize the importance of traditional Chinese medicine (TCM). TCM has been utilized in clinical practice for over 2000 years and is capable of treating a variety of HF pathogenic issues. This review summarizes the classification, pathophysiology, and treatment of HF from three perspectives: Western medicine, TCM, and integrated traditional Chinese and Western medicine (ITCWM). Emphasizing the most recent evidence, this review consolidates knowledge on ITCWM treatments for HF pertaining to different TCM syndromes, including TCM decoctions, oral patent Chinese medicine, TCM injections, as well as therapies like acupuncture and moxibustion. Additionally, this review explores TCM approaches to HF prevention, such as tai chi, Baduanjin exercise, and Sanfu acupoint herbal patching. The findings of this study suggest that ITCWM holds promise for the treatment and rehabilitation of HF. However, further research is warranted to elucidate the underlying mechanisms.

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Role of Thiamine Supplementation in the Treatment of Chronic Heart Failure: An Updated Meta‐Analysis of Randomized Controlled Trials

He,

Wang,

et al. 2024

Clinical Cardiology

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BackgroundChronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains uncertain.HypothesisReceiving supplementary thiamine may not confer benefits to patients with CHF.MethodsA comprehensive search was conducted across the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases up until May 2023 to identify articles investigating the effects of thiamine supplementation in CHF patients. Predefined criteria were utilized for selecting data on study characteristics and results.ResultsSeven randomized, double‐blind, controlled trials (five parallel trials and two crossover trials) involving a total of 274 patients were enrolled. The results of the meta‐analysis pooling these studies did not reveal any significant effect of thiamine treatment compared with placebo on left ventricular ejection fraction (WMD = 1.653%, 95% CI: −1.098 to 4.405, p = 0.239, I2 = 61.8%), left ventricular end‐diastolic volume (WMD = −6.831 mL, 95% CI: −26.367 to 12.704, p = 0.493, I2 = 0.0%), 6‐min walking test (WMD = 16.526 m, 95% CI: −36.582 to 69.634, p = 0.542, I2 = 66.3%), N‐terminal pro‐B type natriuretic peptide (WMD = 258.150 pg/mL, 95% CI: −236.406 to 752.707, p = 0.306, I2 = 21.6%), or New York Heart Association class (WMD = −0.223, 95% CI: −0.781 to 0.335, p = 0.434, I2 = 87.1%). However, it effectively improved the status of thiamine deficiency (TD).ConclusionsOur meta‐analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.

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Current and future therapeutic perspective in chronic heart failure

Cited by 45 publications

References 95 publications

Safety profile of sodium glucose co-transporter 2 (SGLT2) inhibitors: A brief summary

Safety profile of sodium glucose co-transporter 2 (SGLT2) inhibitors: A brief summary

New approach to heart failure: Integrated traditional Chinese with Western medicine

Role of Thiamine Supplementation in the Treatment of Chronic Heart Failure: An Updated Meta‐Analysis of Randomized Controlled Trials

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