JACC Heart Failure, Journal Year: 2024, Volume and Issue: 12(7), P. 1141 - 1156
Published: July 1, 2024
Language: Английский
New England Journal of Medicine, Journal Year: 2023, Volume and Issue: 389(12), P. 1069 - 1084
Published: Aug. 25, 2023
BackgroundHeart failure with preserved ejection fraction is increasing in prevalence and associated a high symptom burden functional impairment, especially persons obesity. No therapies have been approved to target obesity-related heart fraction.MethodsWe randomly assigned 529 patients who had body-mass index (the weight kilograms divided by the square of height meters) 30 or higher receive once-weekly semaglutide (2.4 mg) placebo for 52 weeks. The dual primary end points were change from baseline Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS; scores range 0 100, indicating fewer symptoms physical limitations) body weight. Confirmatory secondary included 6-minute walk distance; hierarchical composite point that death, events, differences KCCQ-CSS C-reactive protein (CRP) level.Download PDF Research Summary.ResultsThe mean was 16.6 8.7 (estimated difference, 7.8 points; 95% confidence interval [CI], 4.8 10.9; P<0.001), percentage −13.3% −2.6% −10.7 CI, −11.9 −9.4; P<0.001). distance 21.5 m 1.2 20.3 m; 8.6 32.1; In analysis point, produced more wins than (win ratio, 1.72; 1.37 2.15; CRP level –43.5% –7.3% treatment 0.61; 0.51 0.72; Serious adverse events reported 35 participants (13.3%) group 71 (26.7%) group.ConclusionsIn obesity, led larger reductions limitations, greater improvements exercise function, loss placebo. (Funded Novo Nordisk; STEP-HFpEF ClinicalTrials.gov number, NCT04788511.) Quick Take Semaglutide Heart Failure Obesity 2m 5s
Language: Английский
Citations
676
Circulation, Journal Year: 2023, Volume and Issue: 148(20), P. 1636 - 1664
Published: Oct. 9, 2023
A growing appreciation of the pathophysiological interrelatedness metabolic risk factors such as obesity and diabetes, chronic kidney disease, cardiovascular disease has led to conceptualization cardiovascular-kidney-metabolic syndrome. The confluence within syndrome is strongly linked for adverse outcomes. In addition, there are unique management considerations individuals with established coexisting factors, or both. An extensive body literature supports our scientific understanding of, approach to, prevention However, critical gaps in knowledge related terms mechanisms development, heterogeneity clinical phenotypes, interplay between social determinants health biological accurate assessments incidence context competing risks. There also key limitations data supporting care syndrome, particularly early-life prevention, screening interdisciplinary models, optimal strategies lifestyle modification weight loss, targeting emerging cardioprotective kidney-protective therapies, patients both impact systematically assessing addressing health. This statement uses a crosswalk major guidelines, addition review literature, summarize evidence fundamental science, screening,
Language: Английский
Citations
254
The Lancet, Journal Year: 2024, Volume and Issue: 403(10437), P. 1635 - 1648
Published: April 1, 2024
Language: Английский
Citations
144
Nature Medicine, Journal Year: 2023, Volume and Issue: 29(9), P. 2358 - 2365
Published: Aug. 27, 2023
In the STEP-HFpEF trial, semaglutide improved symptoms, physical limitations and exercise function reduced body weight in patients with obesity phenotype of heart failure preserved ejection fraction (HFpEF). This prespecified analysis examined effects on dual primary endpoints (change Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS) weight) confirmatory secondary 6-minute walk distance (6MWD), hierarchical composite (death, HF events, change KCCQ-CSS 6MWD) C-reactive protein (CRP)) across classes I-III (body mass index (BMI) 30.0-34.9 kg m
Language: Английский
Citations
118
JACC Advances, Journal Year: 2023, Volume and Issue: 2(6), P. 100452 - 100452
Published: July 28, 2023
Detection of heart failure with preserved ejection fraction (HFpEF) involves integration multiple imaging and clinical features which are often discordant or indeterminate.
Language: Английский
Citations
47
Circulation, Journal Year: 2023, Volume and Issue: 149(3), P. 204 - 216
Published: Nov. 12, 2023
Patients with heart failure (HF) preserved ejection fraction (HFpEF) and obesity experience a high burden of symptoms functional impairment, poor quality life. In the STEP-HFpEF trial (Research Study to Investigate How Well Semaglutide Works in People Living With Heart Failure Obesity), once-weekly semaglutide 2.4 mg improved symptoms, physical limitations, exercise function, reduced inflammation body weight. This prespecified analysis investigated effects on primary confirmatory secondary end points across range Kansas City Cardiomyopathy Questionnaire (KCCQ) scores at baseline all key summary individual KCCQ domains.
Language: Английский
Citations
47
Nature Reviews Disease Primers, Journal Year: 2024, Volume and Issue: 10(1)
Published: Aug. 14, 2024
Language: Английский
Citations
42
Bioactive Materials, Journal Year: 2024, Volume and Issue: 42, P. 270 - 283
Published: Sept. 4, 2024
Language: Английский
Citations
28
Journal of the American College of Cardiology, Journal Year: 2024, Volume and Issue: 84(9), P. 773 - 785
Published: June 24, 2024
More women than men have heart failure with preserved ejection fraction (HFpEF).
Language: Английский
Citations
20
Nature Medicine, Journal Year: 2024, Volume and Issue: unknown
Published: Nov. 17, 2024
Abstract Patients with obesity-related heart failure preserved ejection fraction (HFpEF) display circulatory volume expansion and pressure overload contributing to cardiovascular–kidney end-organ damage. In the SUMMIT trial, patients HFpEF obesity were randomized long-acting glucose-dependent insulinotropic polypeptide receptor glucagon-like peptide-1 agonist tirzepatide ( n = 364, 200 women) or placebo 367, 193 women). As reported separately, decreased cardiovascular death worsening failure. Here, in this mechanistic secondary analysis of treatment at 52 weeks, as compared placebo, reduced systolic blood (estimated difference (ETD) −5 mmHg, 95% confidence interval (CI) −7 −3; P < 0.001), estimated (ETD −0.58 l, CI −0.63 −0.52; 0.001) C-reactive protein levels −37.2%, −45.7 −27.3; 0.001). These changes coupled an increase glomerular filtration rate 2.90 ml min −1 1.73 m −2 yr , 0.94 4.86; 0.004), a decrease urine albumin–creatinine ratio 24 −25.0%, −36 −13%; 0.001; −15%, −28 0.1; 0.051), reduction N-terminal prohormone B-type natriuretic peptide weeks −10.5%, −20.7 1.0%; 0.07) troponin T −10.4%, −16.7 −3.6; 0.003). post hoc exploratory analyses, was significantly correlated pressure, microalbuminuria, improved Kansas City Cardiomyopathy Questionnaire Clinical Summary Score increased 6-min walk distance. Moreover, conclusion, volume–pressure systemic inflammation mitigated injury obesity, providing new insights into mechanisms benefit from tirzepatide. ClinicalTrials.gov registration: NCT04847557 .
Language: Английский
Citations
19