SGLT2 inhibitors may prevent heart failure with preserved ejection fraction in patients with obstructive sleep apnea by enhancing cardiorenal function and reducing visceral and subcutaneous fat.
Do SGLT2 inhibitors provide cardiovascular benefits in patients with HFpEF and obstructive sleep apnea?
This review highlights the potential pathophysiological mechanisms by which SGLT2 inhibitors could benefit patients with HFpEF and obstructive sleep apnea, regardless of diabetes status.
After examining the complex interplay between heart failure (HF) in its various clinical forms, metabolic disorders like nonalcoholic fatty liver disease (NAFLD), and obstructive sleep apnea (OSA) syndrome, in this mini-review we described possible favorable effects of sodium-glucose cotransporter 2 inhibitors (SGLT2is) on HF with preserved (i.e., ≥ 50%) ejection fraction (HFpEF) through enhanced cardiorenal function and visceral-subcutaneous body fat redistribution. In greater detail, on the basis of pathophysiological mechanisms underlying OSA onset and the direct positive SGLT2i effect on renal function benefiting chronic kidney disease, we emphasized the promising role of SGLT2is in prevention, rehabilitation, and treatment of patients with OSA regardless of coexisting type 2 diabetes (T2DM). Indeed, SGLT2is enhance lipolysis and fatty acid beta-oxidation. These phenomena might prevent OSA by reducing the size of visceral and subcutaneous adipose tissue and, as proven in humans and animals with T2DM, counteract NAFLD onset and progression. The aforementioned mechanisms may represent an additional SGLT2i cardioprotective effect in terms of HFpEF prevention in patients with OSA, whose NAFLD prevalence is estimated to be over 50%.
Monda et al. (Fri,) conducted a review in Heart failure with preserved ejection fraction and obstructive sleep apnea. SGLT2 inhibitors was evaluated. SGLT2 inhibitors may prevent heart failure with preserved ejection fraction in patients with obstructive sleep apnea by enhancing cardiorenal function and reducing visceral and subcutaneous fat.