SGLT2 inhibitors are indicated in HF patients irrespective of their diabetes status.

A recent article published in the Current Heart Failure Reports discussed the current clinical evidence for using SGLT2i in different types of HF and illustrates the possible underlying mechanisms.

The findings strongly supported the use of SGLT2i in HF. These drugs not only improve the conventional secondary risk factors of HF, but also benefit HF patients in various multidirectional mechanisms. SGLT2is improve HF status by blood-volume regulation, metabolic effects, reduction of inflammation, cardiorenal mechanisms, improved cardiac remodeling, direct effects on cardiac contractility and ion-homeostasis, and oxidative stress. In addition, these agents affect autophagy and adipokines. 

Although the mechanisms of SGLT2i in HF is yet to be completely defined, clinical and basic evidence supports SGLT2i use in HFrEF and evenHFpEF, owing to their multifactorial effects associated with reduced systemic and myocardial inflammation and improvements of cardiac function. 

Source: Current Heart Failure Reports. 2021 Oct;18(5):315-328. doi: 10.1007/s11897-021-00529-8.