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The most common heart failure phenotype in type 2 diabetes is obesity\u2010related heart failure with a preserved ejection fraction (HFpEF). It has been hypothesized that the synthesis of leptin in this disorder leads to sodium retention and plasma volume expansion as well as to cardiac and renal inflammation and fibrosis. Interestingly, leptin\u2010mediated neurohormonal activation appears to enhance the expression of SGLT2 in the renal tubules, and SGLT2 inhibitors exert natriuretic actions at multiple renal tubular sites in a manner that can oppose the sodium retention produced by leptin. In addition, SGLT2 inhibitors reduce the accumulation and inflammation of perivisceral adipose tissue, thus minimizing the secretion of leptin and its paracrine actions on the heart and kidneys to promote fibrosis. Such fibrosis probably contributes to the impairment of cardiac distensibility and glomerular function that characterizes obesity\u2010related HFpEF. Ongoing clinical trials with SGLT2 inhibitors in heart failure are positioned to confirm or refute the hypothesis that these drugs may favourably influence the course of obesity\u2010related HFpEF by their ability to attenuate the secretion and actions of leptin.<\/jats:p>","DOI":"10.1111\/dom.13229","type":"journal-article","created":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T08:12:53Z","timestamp":1516695173000},"page":"1361-1366","source":"Crossref","is-referenced-by-count":91,"title":["Do sodium\u2010glucose co\u2010transporter\u20102 inhibitors prevent heart failure with a preserved ejection fraction by counterbalancing the effects of leptin? 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