SGLT2抑制剂治疗射血分数保留型心力衰竭的作用机制及临床研究进展

Progress of Clinical Research and Mechanism of Sodium-Glucose Cotransporter 2 Inhibitors in Treatment of Heart Failure with Preserved Ejection Fraction

摘要: 近年来有研究观察到SGLT2抑制剂可以降低HFpEF的心血管死亡或心衰住院等心血管事件风险，而其在HFpEF中的具体作用机制目前尚不明确，SGLT2抑制剂在治疗HFpEF患者中，其提供心脏保护的作用机制涉及降低炎症和氧化应激反应、减少心外膜脂肪组织、纠正细胞质钠和钙稳态失调、抗间质纤维化、改善心肌能量代谢等多个方面，从而使HFpEF患者临床获益。本文旨在探讨SGLT2抑制剂在HFpEF中可能的作用机制及临床研究进展，为SGLT2抑制剂治疗HFpEF患者的作用机制研究提供一定的参考，并为SGLT2抑制剂临床应用作用机制研究的深入开展提供借鉴。

Abstract: Recent investigations have demonstrated that SGLT2 inhibitors can reduce the risk of cardiovascular events, including cardiovascular death or hospitalization due to heart failure in patients with HFpEF. However, the specific mechanisms of action of SGLT2 inhibitors in HFpEF are currently unclear. The potential mechanisms included encompass inflammation and oxidative stress reduction, decrease in epicardial adipose tissue, correction of cytoplasmic sodium and calcium homeostasis, anti-interstitial fibrosis effects and enhancement of myocardial energy metabolism. These mechanisms collectively contribute to the observed clinical benefits in HFpEF patients. This paper aims to summarize the mechanisms of SGLT2 inhibitors in the treatment of patients with HFpEF and the progress of clinical research, providing a reference for the study of the mechanisms of action of SGLT2 inhibitors in treating patients with HFpEF, and offering insights for further research on the clinical application mechanisms of SGLT2 inhibitors.