Cardiovascular risk reduction throughout GLP-1 receptor agonist and SGLT2 inhibitor modulation of epicardial fat

J Endocrinol Invest. 2022 Mar;45(3):489-495. doi: 10.1007/s40618-021-01687-1. Epub 2021 Oct 13.

Abstract

Epicardial adipose tissue is a novel cardiovascular risk factor. It plays a role in the progression of coronary artery disease, heart failure and atrial fibrillation. Given its rapid metabolism, clinical measurability, and modifiability, epicardial fat works well as therapeutic target of drugs modulating the adipose tissue. Epicardial fat responds to glucagon-like peptide 1 receptor agonists (GLP1A) and sodium glucose co-transporter 2 inhibitors (SGLT2i). GLP-1A and SGLT2i provide weight loss and cardiovascular protective effects beyond diabetes control, as recently demonstrated. The potential of modulating the epicardial fat morphology and genetic profile with targeted pharmacological agents can open new avenues in the pharmacotherapy of diabetes and obesity, with particular focus on cardiovascular risk reduction.

Keywords: Diabetes; Epicardial adipose tissue; Epicardial fat; Glucagon like peptide 1 receptor agonists; Heart failure; Obesity; Sodium glucose co-transporter 2 inhibitors.

Publication types

  • Review

MeSH terms

  • Adipose Tissue* / drug effects
  • Adipose Tissue* / metabolism
  • Cardiotonic Agents / pharmacology
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / metabolism
  • Cardiovascular Diseases* / prevention & control
  • Diabetes Mellitus / drug therapy*
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Heart Disease Risk Factors
  • Humans
  • Obesity / drug therapy*
  • Pericardium / pathology*
  • Sodium-Glucose Transporter 2 Inhibitors / pharmacology*
  • Tissue Distribution

Substances

  • Cardiotonic Agents
  • Glucagon-Like Peptide-1 Receptor
  • Sodium-Glucose Transporter 2 Inhibitors