Heart failure (HF) remains a major global health challenge, particularly among aging populations and patients with type 2 diabetes (T2D). Sodium-glucose cotransporter 2 (SGLT2) inhibitors, originally developed as glucose-lowering agents, have demonstrated significant cardiovascular benefits in patients with HF regardless of diabetic status.The reviewed studies indicate that SGLT2 inhibitors may exert cardioprotective effects through the attenuation of oxidative stress, inflammation, mitochondrial dysfunction, apoptosis, and cardiac fibrosis. Several studies have shown that modulation of signaling pathways involving NADPH oxidases, Sirtuin 1, AMPK, and STAT3 contributes to reducing myocardial injury and adverse cardiac remodeling. These findings suggest that the cardiovascular benefits of SGLT2 inhibitors extend beyond glycemic control and may directly influence molecular pathways involved in HF progression.
In conclusion, the reviewed evidence suggests that SGLT2 inhibitors play an important role in attenuating oxidative stress, improving cardiac function, and slowing the progression of heart failure through multiple cardioprotective mechanisms. These findings also highlight the SGLT2 inhibitors may have potential implications for the prevention of cardiovascular diseases and provide important directions for future research.