SGLT2抑制剂在心力衰竭合并心房颤动治疗中的研究进展

Research Progress of SGLT2 Inhibitors in the Treatment of Heart Failure Complicated with Atrial Fibrillation

摘要: 随着世界人口老龄化的不断加剧，心血管疾病已经成为严重威胁人类健康的重要因素，而心力衰竭是众多心血管疾病的终末结点。心力衰竭致心肌纤维化、心脏重塑、肾素–血管紧张素–醛固酮系统(RAAS)激活诱发心房颤动，而心房电与结构重构进一步加重心力衰竭。钠–葡萄糖协同转运蛋白2抑制剂(SGLT2i)作为一种新型降糖药，除了降血糖外，还能够降低心血管疾病死亡率和心力衰竭发生风险，并且在减少心衰合并房颤发生中发挥重要作用。因此，在治疗心力衰竭方面SGLT2抑制剂展现出显著的疗效，使得心力衰竭基础药物治疗标准的“金三角”方案转变为“新四联”方案，心力衰竭药物治疗理念得到革新。本文阐述SGLT2抑制剂在心力衰竭合并心房颤动防治方面最新的研究进展，分别从心脏功能改善、作用机制和安全性等3个方面进行综述。

Abstract: With the increasing aging of the world’s population, cardiovascular disease has become an im-portant factor that seriously threatens human health, and heart failure is the terminal node of many cardiovascular diseases. Heart failure leads to myocardial fibrosis, cardiac remodeling, and activation of renin-angiotensin-aldosterone system (RAAS) to induce atrial fibrillation, while atrial electrical and structural remodeling further aggravates heart failure. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), as a new type of antidiabetic drug, can reduce the mortality of cardiovascular disease and the risk of heart failure in addition to lowering blood glucose, and play an important role in reducing the occurrence of heart failure combined with atrial fibrillation. Therefore, SGLT2 inhibitors have shown significant efficacy in the treatment of heart failure, which has transformed the standard “golden triangle” regimen of basic drug treatment for heart failure into a “new quad-ruple” regimen, and the concept of drug treatment for heart failure has been innovated. This article reviews the latest research progress of SGLT2 inhibitors in the prevention and treatment of heart failure complicated with atrial fibrillation. The improvement of cardiac function, mechanism of ac-tion and safety were reviewed.