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ISGLT-2: El Nuevo Pilar Del Tratamiento De La Falla Cardiaca

Mario Enrique Montoya-Jaramillo, Daniela Salcedo-Restrepo, Jorge Armando Fuentes-Romero, David Fernando Ortiz-Pérez, Ricardo Andrés Donado-Botero, Katherin Portela-Buelvas, Blanca Meza-Santiago.

Background: Heart failure is a clinical syndrome characterized by impaired quality of life, frequent use of medical services, and premature mortality. Its prevalence is between 1% and 14% in the US and European population, for Colombia a prevalence of approximately 2.3% of the population is estimated; 1, 2 recent studies point to an increase in the number of deaths from this aetiology in the United States, from 275,000 in 2009 to 310,000 in 2014, this associated with a phenomenon in which there is an increase in the life expectancy of heart patients, in addition to population aging.

Methodology: A bibliographic review was carried out through various databases from 2016 to 2022; The search and selection of articles was carried out in indexed journals in English and Spanish. Key words were used: Heart Failure; Sodium-glucose transporter type 2 inhibitors; Diabetes mellitus type 2; antidiabetic agents.

Results: ISGLT-2 have a mechanism of action in the first instance due to nutriereis and glycosuria since it decreases preload and afterload, this is responsible for reducing interstitial edema which is associated with ventricular hypertrophy, it also decreases BP , sympathetic tone due to direct inhibition of norepinephrine synthesis due to renal tyrosine hydroxylase blockade, another mechanism is the reduction of glucose consumption given to the cardiomyocyte in favor of fatty acid and acetone consumption.

Conclusion: Sodium-glucose cotransporter type 2 inhibitors have shown benefits on morbidity and mortality in patients with heart failure with preserved and decreased ejection fraction, as well as improvements on diseases such as metabolic syndromes, kidney disease, and sudden death.