Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2024; 16(11): 669-672
Published online Nov 26, 2024. doi: 10.4330/wjc.v16.i11.669
SGLT2 inhibitors in the prevention of diabetic cardiomyopathy: Targeting the silent threat
Panayotis K Vlachakis, Panagiotis Theofilis, Dimitris Tousoulis
Panayotis K Vlachakis, Panagiotis Theofilis, Department of 1st Cardiology, General Hospital of Athens “Hippocratio”, University of Athens Medical School, Athens 11527, Greece
Dimitris Tousoulis, Department of 1st Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
Co-first authors: Panayotis K Vlachakis and Panagiotis Theofilis.
Author contributions: Vlachakis PK contributed to investigation and writing-original draft; Theofilis P contributed to investigation and writing-original draft; Tousoulis D supervised the project and contributed to writing-review and editing.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dimitris Tousoulis, PhD, Professor, Department of 1st Cardiology, Athens Medical School, National and Kapodistrian University of Athens, Mantouvalou 3, Athens 11527, Greece. drtousoulis@hotmail.com
Received: September 2, 2024
Revised: September 26, 2024
Accepted: October 20, 2024
Published online: November 26, 2024
Processing time: 58 Days and 19.8 Hours
Abstract

Heart failure (HF) is a major global health challenge, particularly among individuals with type 2 diabetes mellitus (T2DM), who are at significantly higher risk of developing HF. Diabetic cardiomyopathy, a unique form of heart disease, often progresses silently until advanced stages. Recent research has focused on sodium-dependent glucose transporter 2 inhibitors (SGLT2i), originally developed for hyperglycemia, which have shown potential in reducing cardiovascular risks, including HF hospitalizations, irrespective of diabetic status. In this editorial we comment on the article by Grubić Rotkvić et al published in the recent issue of the World Journal of Cardiology. The investigators examined the effects of SGLT2i on myocardial function in T2DM patients with asymptomatic HF, finding significant improvements in stroke volume index and reductions in systemic vascular resistance, suggesting enhanced cardiac output. Additionally, SGLT2i demonstrated anti-inflammatory and antioxidant effects, as well as blood pressure reduction, though the study’s limitations—such as small sample size and observational design—necessitate larger randomized trials to confirm these findings. The study underscores the potential of early intervention with SGLT2i in preventing HF progression in T2DM patients.

Keywords: Sodium-dependent glucose transporter 2 inhibitor; Diabetes mellitus; Heart failure; Pathophysiology; Inflammation; Oxidative stress

Core Tip: Sodium-dependent glucose transporter 2 inhibitors show promise in improving cardiac function and reducing cardiovascular risks in patients with type 2 diabetes mellitus and asymptomatic heart failure (HF). Early intervention with these drugs could be key in preventing the progression of diabetic cardiomyopathy, making them an important consideration in managing high-risk diabetic patients before symptoms of HF emerge.