Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as powerful drugs that can be used to treat heart failure (HF) patients, both with preserved and reduced ejection fraction and in the presence or absence of type 2 diabetes. While the mechanisms underlying the salutary effects of SGLT2 inhibitors have not been fully elucidated, there is clear evidence for a beneficial metabolic effect of these drugs. In this review, we discuss the effects of SGLT2 inhibitors on cardiac energy provision secondary to ketone bodies, pathological ventricular remodeling, and inflammation in patients with HF. While the specific contribution of ketone bodies to the pleiotropic cardiovascular benefits of SGLT2 inhibitors requires further clarification, ketone bodies themselves may also be used as a therapy for HF.

Stress is a natural state that emerges due to the dynamics of an individual’s life. Children must learn how to effectively manage stress as part of their growth and development. Resolution is possible when children are exposed to stress and receive adequate support from their families. However, when stress is intense, frequent, protracted, or traumatic, as in cases of childhood abuse, it can become toxic and interfere with the development of the child’s brain and body. This results in vulnerability, which can have detrimental effects on the child’s overall physical, mental, and emotional health. This perspective discusses the impact of childhood maltreatment and toxic stress, drawing on insights gained during the COVID-19 pandemic. We aimed to shed light on the lessons learned from this unique and challenging period and how they inform our understanding of the effects of stress on children’s well-being.