Type 2 diabetes (T2D) is associated with an increased risk of heart failure (HF), with recent reports indicating that HF with preserved ejection fraction (HFpEF) may be more common than HF with reduced ejection fraction (HFrEF) in patients with T2D. T2D and HF result in worse outcomes than either disease alone. Sodium-glucose co-transporter-2 inhibitors (SGLT-2is) have significantly improved HF outcomes in patients with T2D and may represent a new therapeutic alternative for patients with T2D at risk for or with HF. Current guidelines recommend prevention of HF through risk factor management. Once developed, treatment of HFrEF should include neurohormonal and haemodynamic modulations; however, there are no specific treatments available for HFpEF. SGLT-2is are the first class of glucose-lowering therapy to prevent HF in clinical trials and real-world studies in patients with T2D (with or without established cardiovascular disease and with or without baseline HF). Mechanistic studies suggest that SGLT-2is have beneficial effects on both systolic and diastolic function and additional systemic effects that could benefit HF outcomes. In patients with HFrEF, SGLT-2i treatment as add-on to standard HF therapy has had beneficial effects on HF outcomes, irrespective of T2D status. These results and those of ongoing outcomes trials with SGLT-2is may help establish this drug class as a treatment for HF in patients with HFrEF and HFpEF, as well as HF in patients without T2D.

中文翻译：

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在患有和不患有2型糖尿病的患者中使用钠-葡萄糖共转运蛋白2抑制剂：对事件和普遍的心力衰竭的影响。

2型糖尿病（T2D）与心力衰竭（HF）风险增加相关，最近的报道表明，在T2D患者中，射血分数保留的HF（HFpEF）可能比射血分数降低的HF（HFrEF）更常见。与单独的任何一种疾病相比，T2D和HF导致的结局均较差。钠-葡萄糖共转运蛋白2抑制剂（SGLT-2is）可以显着改善T2D患者的HF结果，并且可能代表患有HF或患有HF的T2D患者的新治疗选择。当前的指南建议通过危险因素管理预防心力衰竭。一旦发展，HFrEF的治疗应包括神经激素和血流动力学调节。但是，目前尚无针对HFpEF的特定治疗方法。SGLT-2是在T2D患者（有或没有心血管疾病和有或没有基线HF）的临床试验和实际研究中，用于预防HF的第一类降糖疗法。机理研究表明，SGLT-2对收缩功能和舒张功能均具有有益作用，并可能有益于HF结果的其他全身作用。在HFrEF患者中，SGLT-2i治疗是标准HF治疗的附加手段，无论T2D状态如何，对HF结局都有有益的影响。这些结果以及正在进行的SGLT-2is结局试验的结果可能有助于将该药物类别确立为HFrEF和HFpEF患者以及没有T2D患者的HF治疗HF的方法。机理研究表明，SGLT-2对收缩和舒张功能均具有有益作用，并可能有益于HF结果的其他全身作用。在HFrEF患者中，SGLT-2i治疗是标准HF治疗的附加手段，无论T2D状态如何，对HF结局都有有益的影响。这些结果以及正在进行的SGLT-2is结果试验的结果，可能有助于将该药物类别确立为HFrEF和HFpEF患者以及无T2D患者的HF治疗HF的方法。机理研究表明，SGLT-2对收缩和舒张功能均具有有益作用，并可能有益于HF结果的其他全身作用。在HFrEF患者中，SGLT-2i治疗是标准HF治疗的附加手段，无论T2D状态如何，对HF结局都有有益的影响。这些结果以及正在进行的SGLT-2is结果试验的结果，可能有助于将该药物类别确立为HFrEF和HFpEF患者以及无T2D患者的HF治疗HF的方法。