Emerging Role of Sodium-Glucose Cotransporter-2 Inhibitors in Aortic Stenosis
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as a key drug class in the management of heart failure, expanding far beyond their original use in type 2 diabetes mellitus. Aortic stenosis (AS), the most common valvular heart disease in the aging population, is characterized by progressive valve calcification and chronic left ventricular pressure overload. No disease-modifying pharmacologic treatment has yet been found to slow AS progression or to prevent myocardial remodeling in AS. The authors review the mechanistic rationale for SGLT2 inhibition in the pressure-overloaded heart and summarize the emerging evidence in AS. The authors propose that SGLT2 inhibition may represent a promising strategy targeting both myocardial remodeling and valvular disease biology in AS, warranting further investigation in dedicated trials.
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