The Role of SGLT2-Inhibitors in Heart Failure Management

Abstract

Sodium-glucose cotransporter-2 inhibitors (SGLT2i), originally designed as anti-hyperglycaemic medicines, later transformed into heart failure (HF) care, providing significant advantages at all phenotypes and stages of heart failure disease. Despite left ventricular ejection fraction (LVEF), these medicines have demonstrated benefit in acute and chronic heart failure. This article investigates sodium-glucose cotransporter-2 inhibitors use across the heart failure field, from primary stages (Stage A) in patients at risk to the advanced reduction in progressive heart failure (Stage D). Several studies have demonstrated that SGLT2i substantially reduces HF hospitalization rates, improves kidney function, and lowers cardiovascular death cases, underlining their complex pharmacodynamics in heart failure therapy.
This review article discusses the probable mechanisms by which sodium-glucose cotransporter-2 inhibitors exercise their favourable effects on the renal and cardiovascular systems, with each conducive to short and long-term therapeutic benefits.
However, integrating SGLT2i into medical treatment presents practical problems such as commencement time, dose, and monitoring, which must be addressed in order to achieve optimal therapy revision among different patients. Finally, this review also offers a thorough evaluation of SGLT2i as an initial therapy in heart failure, stressing its title role as a multistage involvement aiming at developing consequences across the heart failure field.