SLC9A3 and hydrops fetalis: In addition, SGLT-2 inhibitors inhibit the Na +/H + exchanger (NHE) 1 in the myocardium results and NHE3 in the proximal tubule, resulting in decreased cytoplasmic sodium and calcium levels while increasing mitochondrial calcium level and inhibiting sodium reabsorption, all of which help to explain the reduction in HF with this drug class [46, 50].