Why the study?
The mechanisms responsible for the unexpected positive cardiovascular effects of SGLT2 inhibitors and GLP-1 receptor agonists in patients with type 2 diabetes remain to be defined.
Case Report (n=1)
No
The cardiovascular benefits of SGLT2 inhibitors and GLP-1 receptor agonists in type 2 diabetes may be partially mediated by favorable alterations in myocardial metabolism.
May link myocardial metabolic shifts to CV protection from SGLT2i/GLP-1RA; leaves open prospective validation in cardiometabolic cohorts.
The mechanisms responsible for the positive and unexpected cardiovascular effects of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes remain to be defined. It is likely that some of the beneficial cardiac effects of these antidiabetic drugs are mediated, in part, by altered myocardial metabolism. Common cardiometabolic disorders, including the metabolic (insulin resistance) syndrome and type 2 diabetes, are associated with altered substrate utilization and energy transduction by the myocardium, predisposing to the development of heart disease. Thus, the failing heart is characterized by a substrate shift toward glycolysis and ketone oxidation in an attempt to meet the high energetic demand of the constantly contracting heart. This review examines the metabolic pathways and clinical implications of myocardial substrate utilization in the normal heart and in cardiometabolic disorders, and discusses mechanisms by which antidiabetic drugs and metabolic interventions improve cardiac function in the failing heart.
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Honka et al. (2021) conducted a case report in Fulminant myocarditis due to COVID-19 (n=1). Extracorporeal membrane oxygenation (ECMO) and mechanical circulatory support was evaluated.
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