Advances in therapySep 16, 2022

Heart Failure with Normal Pumping and Sleep Apnea: Possible Extra Heart Benefits of SGLT2 Inhibitors in People With or Without Type 2 Diabetes

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Apr 1, 2026

Abstract

(SGLT2is) may have favorable effects on (HFpEF) and (OSA).

SGLT2is could enhance heart and kidney function, particularly in patients with HFpEF.
These medications may help redistribute body fat, reducing visceral and subcutaneous adipose tissue.
SGLT2is are associated with increased fat breakdown and fatty acid oxidation.
There is potential for SGLT2is to prevent the onset and progression of nonalcoholic fatty liver disease (NAFLD) in individuals with type 2 diabetes.
The prevalence of NAFLD in patients with OSA is estimated to exceed 50%, highlighting a significant overlap between these conditions.

Simplified

After examining the complex interplay between heart failure (HF) in its various clinical forms, metabolic disorders like nonalcoholic fatty liver disease (NAFLD), and (OSA) syndrome, in this mini-review we described possible favorable effects of (SGLT2is) on HF with preserved (i.e., ≥ 50%) ejection fraction () through enhanced cardiorenal function and visceral-subcutaneous body fat redistribution. In greater detail, on the basis of pathophysiological mechanisms underlying OSA onset and the direct positive SGLT2i effect on renal function benefiting chronic kidney disease, we emphasized the promising role of SGLT2is in prevention, rehabilitation, and treatment of patients with OSA regardless of coexisting type 2 diabetes (T2DM). Indeed, SGLT2is enhance lipolysis and fatty acid beta-oxidation. These phenomena might prevent OSA by reducing the size of visceral and subcutaneous adipose tissue and, as proven in humans and animals with T2DM, counteract NAFLD onset and progression. The aforementioned mechanisms may represent an additional SGLT2i cardioprotective effect in terms of HFpEF prevention in patients with OSA, whose NAFLD prevalence is estimated to be over 50%.

Key numbers

40–50%

Prevalence of

accounts for approximately 40–50% of incident heart failure overall.

48%

Prevalence of in Heart Failure Patients

was present in 48% of patients with heart failure.

0.77

SGLT2i Effect on Cardiovascular Events

Hazard ratio for cardiovascular death and hospitalization in patients treated with .

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Heart Failure with Normal Pumping and Sleep Apnea: Possible Extra Heart Benefits of SGLT2 Inhibitors in People With or Without Type 2 Diabetes

Abstract

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