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Resumen: Los inhibidores del cotransportador de sodio y glucosa tipo 2 (i-SGLT2) ejercen su efecto hipoglucemiante a través de la inhibición de la reabsorción de glucosa en el riñón. Sin embargo, los efectos cardiovasculares, renales y en falla cardiaca parecen ocurrir de manera independiente al efecto hipoglucemiante de estos fármacos. Los principales mecanismos de acción que explican sus beneficios cardiovasculares son el efecto hipotensor y la disminución en las presiones de llenado, efectos directos en el metabolismo de la célula miocárdica, reducción de la microalbuminuria, efectos metabólicos no glicémicos y disminución del tejido adiposo, aumento del hematocrito y uricosuria. En este artículo se describe cada uno de estos mecanismos novedosos. Abstract: Type 2 Sodium-Glucose Cotransporter (SGLT2) Inhibitors exercise their glucose-lowering effect through the inhibition of glucose reabsorption in the kidney. However, the cardiovascular and renal effects, as well as in those of cardiac failure, seem to occur independently from the glucose–lowering effects of these drugs. The principal mechanisms of action that explain their cardiovascular benefits are the hypotensive effect and the decrease in fill pressures, as well as direct effects on the metabolism of the myocardial cell. There is also a reduction in the urine albumin, as well as non-glycaemic effects, and a decrease in adipose tissue, with an increase in haematocrit and urine uric acid. Each one of these novel mechanisms is described in this article. Palabras clave: Diabetes, Insuficiencia cardiaca, Tratamiento, Keywords: Diabetes, Heart failure, Treatment |
