Ингибиторы натрий - глюкозного котранспортера 2-го типа и сердечные аритмии
DOI:
https://doi.org/10.52692/1857-0011.2025.1-81.09Ключевые слова:
Ингибиторы натрий-глюкозного котранспортера 2-го типа, аритмииАннотация
Ингибиторы натрий - глюкозного котранспортера 2-го типа (иНГКТ-2), разработанные изначально как новый препарат для снижения уровня глюкозы, продемонстрировали в крупных исследованиях спектр благоприятных сердечно-сосудистых эффектов, снижение риска сердечно-сосудистых событий. Ретроспективный анализ данных этих проспективных исследований указал на статистически значимую связь иНГКТ-2 с частотой нарушений сердечного ритма. В литературе опубликованы результаты единичных проспективных исследований, которые изучали антиаритмические эффекты иНГКТ-2. Данные клинических и фундаментальных исследований предполагают, что антиаритмические эффекты иНГКТ-2 основаны на снижении гемодинамической нагрузки и улучшении функции сердца, предотвращении ремоделирования миокарда, модуляции сердечных ионных каналов; однако точный механизм требует дальнейшего изучения.
Библиографические ссылки
Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med., 2015;373(22):2117–2
Vaduganathan M, Docherty KF, Claggett BL, et al. SGLT-2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials. Lancet. 2022; 400(10354):757–67.
Wu JH, Foote C, Blomster J, et al. Effects of sodium- glucose cotransporter-2 inhibitors on cardiovascular events, death, and major safety outcomes in adults with type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol., 2016;4(5):411–9
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J., 2021;42(36):3599–726.
Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the management of Heart failure: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice guidelines. Circulation. 2022;145(18):e876–94.
McDonagh TA, Metra M, Adamo M, et al. 2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J., 2023;44(37) : 3627–39.
Ferrannini E, Baldi S, Frascerra S, et al. Shift to fatty substrate utilization in response to sodiumglucose cotransporter 2 inhibition in subjects without diabetes and patients with type 2 diabetes. Diabetes. 2016;65(5):1190–5
Heerspink H, Perco P, Mulder S, et al. Canagliflozin reduces inflammation and fibrosis biomarkers: a potential mechanism of action for beneficial effects of SGLT2 inhibitors in diabetic kidney disease. Diabetologia. 2019;62(7):1154–66
Yaribeygi H, Atkin SL, Butler AE, et al. Sodiumglucose cotransporter inhibitors and oxidative stress: an update. J Cell Physiol., 2019;234(4):3231–7.
Kang S, Verma S, Hassanabad AF, et al. Direct effects of empagliflozin on extracellular matrix remodelling in human cardiac myofibroblasts: novel translational clues to explain EMPAREG OUTCOME results. Can J Cardiol., 2020;36(4):543–53
Zelniker TA, Bonaca MP, Furtado RHM, et al. Effect of dapagliflozin on atrial fibrillation in patients with type 2 diabetes mellitus. Circulation. 2020;141(15):1227– 34.
Li HL, Lip GYH, Feng Q, et al. Sodium- glucose cotransporter 2 inhibitors (SGLT2i) and cardiac arrhythmias: a systematic review and metaanalysis. Cardiovasc Diabetol., 2021;20(1): 100 -110.
Li D, Liu Y, Hidru TH, et al. Protective effects of sodium-glucose transporter 2 inhibitors on atrial fibrillation and atrial flutter: a systematic review and meta-analysis of randomized placebo-controlled trials. Front Endocrinol., 2021. https://doi.org/10.3389/fendo.2021.619586.
Li W, Chen X, Xie X, et al. Comparison of sodium- glucose cotransporter 2 inhibitors and glucagon-like peptide receptor agonists for atrial fibrillation in type 2 diabetes mellitus: systematic review with network meta- analysis of randomized controlled trials. J Cardiovasc Pharmacol., 2022;79(3):281–8.
Ong HT, Teo YH, Teo YN, et al. Effects of sodium/ glucose cotransporter inhibitors on atrial fibrillation and stroke: a meta-analysis. J Stroke Cerebrovasc Dis., 2022;31(1):106159. https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106159.
Pandey AK, Okaj I, Kaur H, et al. Sodium- glucose co-transporter inhibitors and atrial fibrillation: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc Cardiovasc Cerebrovasc Dis., 2021;10(17): e022222. https://doi.org/10.1161/JAHA.121.022222.
Zheng RJ, Wang Y, Tang JN, et al. Association of SGLT2 inhibitors with risk of atrial fibrillation and stroke in patients with and without type 2 diabetes: a systemic review and meta-analysis of randomized controlled trials. J Cardiovasc Pharmacol., 2022;79(2):e145–52.
Fernandes GC, Fernandes A, Cardoso R, et al. Association of SGLT2 inhibitors with arrhythmias and sudden cardiac death in patients with type 2 diabetes or heart failure: a meta-analysis of 34 randomized controlled trials. Heart Rhythm. 2021;18(7):1098–105.
Chen HY, Huang JY, Siao WZ, Jong GP. The association between SGLT2 inhibitors and new-onset arrhythmias: a nationwide population-based longitudinal cohort study. Cardiovasc Diabetol., 2020;19(1):73-81.
Sfairopoulos D, Liu T, Zhang N, et al. Association between sodium-glucose cotransporter-2 inhibitors and incident atrial fibrillation/atrial flutter in heart failure patients with reduced ejection fraction: a meta-analysis of randomized controlled trials. Heart Fail Rev., 2023;28(4): 925–36.
Bonora BM, Raschi E, Avogaro A, Fadini GP. SGLT- 2 inhibitors and atrial fibrillation in the Food and Drug Administration adverse event reporting system. Cardiovasc Diabetol., 2021; 20(1):39. https://doi.org/10.1186/s12933-021-01243-4
Liao J, Ramin Ebrahimi R, Ling Z, et al. Effect of SGLT-2 inhibitors on arrhythmia events: insight from an updated secondary analysis of > 80,000 patients (the SGLT2i Arrhythmias and Sudden Cardiac Death). Cardiovascular Diabetology. 2024; 23:78 https://doi.org/10.1186/s12933-024-02137-x
Kishima H, Mine T, Fukuhara E, et al. Efficacy of sodium-glucose cotransporter 2 inhibitors on outcomes after catheter ablation for atrial fibrillation. JACC Clin Electrophysiol., 2022; 8(11):1393–404.
Abu-Qaoud MR, Kumar A, Tarun T, et al. Impact of SGLT2 inhibitors on AF recurrence after catheter ablation in patients with type 2 diabetes. JACC Clin Electrophysiol., 2023;9(10): 2109–18.
Luo F, Sun L, Wang Z, et al. Effect of dapagliflozin on the outcome of radiofrequency catheter ablation in patients with type 2 diabetes mellitus and atrial fibrillation. Cardiovasc Drugs Ther., 2024;38(1). 10.1007/s10557-022-07368-2
Curtain JP, Docherty KF, Jhund PS, et al. Effect of dapagliflozin on ventricular arrhythmias, resuscitated cardiac arrest, or sudden death in DAPA-HF. Eur Heart J., 2021;42(36):3727–38.
Oates CP, Santos-Gallego CG, Smith A, et al. SGLT2 inhibitors reduce sudden cardiac death risk in heart failure: meta-analysis of randomized clinical trials. J Cardiovasc Electrophysiol., 2023;34(5):1277–85.
Yin Z, Zheng H, Guo Z. Effect of sodium-glucose co-transporter protein 2 inhibitors on arrhythmia in heart failure patients with or without type 2 diabetes: a meta-analysis of randomized controlled trials. Front Cardiovasc Med., 2022;9: 902923. https://doi.org/10.3389/fcvm.2022.902923
Fawzy AM, Rivera-Caravaca JM, Underhill P, et al. Incident heart failure, arrhythmias and cardiovascular outcomes with sodium-glucose cotransporter 2 (SGLT2) inhibitor use in patients with diabetes: insights from a global federated electronic medical record database. Diabetes Obes Metab., 2023;25(2):602–10
Fujiki S, Iijima K, Nakagawa Y, et al. Effect of empagliflozin on ventricular arrhythmias in patients with type 2 diabetes treated with an implantable cardioverter- defibrillator: the EMPA-ICD trial. Cardiovasc Diabetol., 2024;23:224. DOI: 10.1186/s12933-024-02309-9.
Benedikt M, Oulhaj A, Rohrer U, et al. Ertugliflozin to reduce arrhythmic burden in patients with ICDs/CRT-Ds. NEJM Evid., 2024;3(10). DOI: 10.1056/EVIDoa2400147.
Paul A, Tabaja C, Wazni O. SGLT2 inhibitors and the cardiac rhythm: unraveling the connections. International Journal of Arrhythmia. 2024; 25:2-14 https://doi.org/10.1186/s42444-024-00109-6
Na Li N, Chelu MG, Birnbaum Y. Dapagliflozin for Atrial Fibrillation. Cardiovasc Drugs Ther., 2024; 38(1): 1–3. doi:10.1007/s10557-024-07543-7
Bertero E, Prates Roma L, Ameri P, Maack C. Cardiac effects of SGLT2 inhibitors: the sodium hypothesis. Cardiovasc Res., 2018;114 (1):12–18.
Lee TI, Chen YC, Lin YK, et al. Empagliflozin attenuates myocardial sodium and calcium dysregulation and reverses cardiac remodeling in streptozotocin-induced diabetic rats. Int J Mol Sci., 2019;20 (7):1680
Duan H-Y, Barajas-Martinez H, Antzelevitch C, Hu D. The potential anti-arrhythmic effect of SGLT2 inhibitors. Cardiovascular Diabetology. 2024; 23:252 https://doi.org/10.1186/s12933-024-02312-0
Paasche A, Wiedmann F, Kraft M, et al. Acute antiarrhythmic effects of SGLT2 inhibitors-dapagliflozin lowers the excitability of atrial cardiomyocytes. Basic Res Cardiol., 2024;119(1): 93–112.
Gazmuri RJ, Radhakrishnan J, Ayoub IM. Sodium- hydrogen exchanger Isoform-1 inhibition: a promising pharmacological intervention for resuscitation from cardiac arrest. Molecules. 2019;24(9):1765
Tang H, Zhang X, Zhang J, et al. Elevated serum magnesium associated with SGLT2 inhibitor use in type 2 diabetes patients: a meta-analysis of randomised controlled trials. Diabetologia. 2016;59(12):2546–51.
Packer M. Autophagy stimulation and intracellular sodium reduction as mediators of the cardioprotective effect of sodium-glucose cotransporter 2 inhibitors. Eur J Heart Fail., 2020; 22(4):618–28.
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