EFICÁCIA CLÍNICA E IMPACTO PROGNÓSTICO DOS INIBIDORES DO COTRANSPORTADOR SÓDIO-GLICOSE TIPO 2 (ISGLT2) NA INSUFICIÊNCIA CARDÍACA COM FRAÇÃO DE EJEÇÃO PRESERVADA: UMA REVISÃO INTEGRATIVA

Introduction: Heart Failure with Preserved Ejection Fraction (HFpEF) is a prevalent clinical condition that historically represented a therapeutic gap in cardiology due to the lack of treatments capable of reducing mortality. This scenario changed with the advent of Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i), which emerged as a fundamental new class in the management of this syndrome. Objective: To analyze the clinical efficacy and prognostic impact of SGLT2 inhibitors in adult patients with HFpEF, investigating their effects on morbidity, mortality, and quality of life. Methodology: This is an integrative literature review based on the analysis of 10 articles selected from PubMed and SciELO databases, published between 2020 and 2026. Data were extracted and synthesized into three thematic axes: impact on morbidity, cardiovascular mortality, and cardiometabolic mechanisms. Results: The analysis revealed that the use of SGLT2i (such as empagliflozin and dapagliflozin) promotes clinically significant improvements in quality of life and functional capacity (KCCQ and NYHA scores). Prognostically, a robust reduction in the risk of composite outcomes was observed, driven by decreased hospitalizations and cardiovascular mortality, regardless of diabetes status. Benefits are sustained by pleiotropic mechanisms, including natriuresis, congestion reduction, and nephroprotection. Conclusion: SGLT2i consolidate themselves as a central pillar and paradigm shift in HFpEF treatment, filling the historic therapeutic gap. Current evidence supports the mandatory and early incorporation of this pharmacological class to modify the natural history of the disease, improve survival, and reduce the morbidity burden in this population.