Korean Circ J.  2021 Mar;51(3):251-262. 10.4070/kcj.2020.0303.

Sodium/glucose Co-Transporter 2 Inhibitor, Empagliflozin, Alleviated Transient Expression of SGLT2 after Myocardial Infarction

• Lee SY
• Lee TW
• Park GT
• Kim JH
• Lee HC
• Han JH
• Yoon A
• Yoon D
• Kim S
• Jung SM
• Choi JH
• Chon MK
• Lee SH
• Hwang KW
• Kim J
• Park YH
• Kim JH
• Chun KJ
• Hur J

• KMID: 2513523
• DOI: http://doi.org/10.4070/kcj.2020.0303

Abstract

Background and Objectives
Large clinical studies of sodium/glucose cotransporter 2 (SGLT2) inhibitors have shown a significant beneficial effect on heart failure-associated hospitalization and cardiovascular events. As SGLT2 is known to be absent in heart cells, improved cardiovascular outcomes are thought to be accounted for by the indirect effects of the drug. We sought to confirm whether such benefits were mediated through SGLT2 expressed in the heart using myocardial infarction (MI) model.
Methods
Mice pre-treated with empagliflozin (EMPA), an SGLT2 inhibitor, showed a significantly reduced infarct size compared with the vehicle group three days post-MI. Interestingly, we confirmed SGLT2 localized in the infarct zone. The sequential changes of SGLT2 expression after MI were also evaluated.
Results
One day after MI, SGLT2 transiently appeared in the ischemic areas in the vehicle group and increased until 72 hours. The appearance of SGLT2 was delayed and less in amount compared with the vehicle group. Additionally, there was a significant difference in metabolites, including glucose and amino acids in the 1 H nuclear magnetic resonance analysis between groups.
Conclusions
Our work demonstrates that SGLT2 is transiently expressed in heart tissue early after MI and EMPA may directly operate on SGLT2 to facilitate metabolic substrates shifts.

Keyword

Myocardial infarction; Sodium-glucose transporter 2; Sodium-glucose transporter 2 inhibitors; Metabolism

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