Current Trends in the Treatment of Heart Failure in Patients with Diabetes Mellitus and Ejection Fraction: An Analysis of the Relationship between SGLT2 and Heart Failure

Abstract

Introduction: the use of glyflozines, a group of drugs, in the treatment of heart failure, diabetes mellitus and chronic kidney disease is analyzed. To highlight the pathophysiological mechanisms shared between these diseases and the increased risk of cardiovascular events in patients with these conditions. Glyflozines have shown benefits in all three diseases mentioned, surprising researchers for their cardiovascular effects. The article mentions the association between type 2 diabetes mellitus (DM2) and heart failure, as well as the increased risk of cardiovascular disease in patients with DM2. Objectives: to analyze the two isoforms of sodium-glucose transporters (SGLT1 and SGLT2) and the role of SGLT2 inhibitors in promoting osmotic diuresis and glucose excretion, in relation to treatment for heart failure, diabetes mellitus and chronic kidney disease. Methods: a Systematic Review of the literature was performed, which will be governed according to PRISMA guidelines. The units of analysis will be abstracts and full text of articles with randomized clinical trial design or prospective or retrospective cohort, published in Scopus, Web of Science and Pubmed, without temporal restriction. Results: the results of this review strongly support the inclusion of T2GLS in the management strategies of heart failure in patients with diabetes mellitus. Furthermore, they suggest that these drugs can have a positive clinical impact in patients with different profiles, making them a versatile option. However, further research is needed to deepen the mechanisms of action and to explore their efficacy in patients with heart failure and preserved ejection fraction, as well as in other subgroups of clinical interest. The incorporation of SGLT2 into current and future clinical practice may represent a significant advance in the treatment of heart failure and improve the quality of life of affected patients. Future research should focus on addressing outstanding questions and areas of uncertainty to better guide clinical decision making and improve outcomes for patients with heart failure and diabetes mellitus.