SGLT2 INHIBITORS AND MYOCARDIAL REMODELING IN PROSTATE CANCER PATIENTS: THE ROLE OF SPECKLE TRACKING ECHOCARDIOGRAPHY (GLS)
Keywords:
SGLT2 inhibitors; myocardial remodeling; prostate cancer; cardio-oncology; speckle-tracking echocardiography; global longitudinal strain (GLS); cardiotoxicityAbstract
In recent years, sodium-glucose cotransporter 2 (SGLT2) inhibitors have been considered not only as effective hypoglycemic agents but also as agents with proven cardioprotective properties. Patients with prostate cancer are at increased cardiovascular risk due to age-related factors, associated metabolic disorders, and the use of androgen deprivation therapy, which contributes to the development of myocardial dysfunction and pathological remodeling. Speckle-tracking echocardiography with assessment of global longitudinal strain (GLS) of the left ventricle is of particular importance in the early diagnosis of subclinical myocardial contractility disorders. This indicator enables the detection of early myocardial changes before a decrease in ejection fraction and clinical manifestations of heart failure.
This review article summarizes current data on the mechanisms of myocardial remodeling in patients with prostate cancer, the potential cardioprotective effects of SGLT2 inhibitors, and the diagnostic and prognostic value of GLS in cardio-oncology practice. The role of an integrated approach, including pharmacological cardioprotection and modern imaging methods, in reducing cardiovascular complications and improving the prognosis in this patient population is emphasized.
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