Current Opinion in Cardiology,
Journal Year:
2024,
Volume and Issue:
39(3), P. 148 - 153
Published: Jan. 31, 2024
Purpose
of
review
Incretin-based
drugs
are
potent
weight-lowering
agents,
emerging
as
potential
breakthrough
therapy
for
the
treatment
obesity-related
phenotype
heart
failure
with
preserved
ejection
fraction
(HFpEF).
In
this
article,
we
will
discuss
contribution
weight
loss
part
benefits
incretin-based
medications
in
obese
patients
HFpEF.
Furthermore,
describe
effects
glucagon-like
peptide-1
(GLP-1)
and
glucose-dependent
insulinotropic
polypeptide
(GIP)
receptor
agonists
on
heart,
particularly
relation
to
HFpEF
pathophysiology.
Recent
findings
STEP-HFpEF
trial,
GLP-1
agonist
semaglutide
significantly
improved
quality
life
outcomes
patients.
Whether
beneficial
merely
a
consequence
body
reduction
is
unclear.
Considering
availability
other
strategies
(e.g.,
caloric
restriction,
exercise
training,
bariatric
surgery)
be
used
patients,
answering
question
crucial
provide
tailored
therapeutic
options
these
subjects.
Summary
may
represent
milestone
obesity
Elucidating
overall
benefit
observed
critical
management
considering
that
available
might
alternative
Diabetes Care,
Journal Year:
2024,
Volume and Issue:
unknown
Published: June 6, 2024
The
development
of
glucagon-like
peptide
1
receptor
agonists
(GLP-1RA)
for
type
2
diabetes
and
obesity
was
followed
by
data
establishing
the
cardiorenal
benefits
GLP-1RA
in
select
patient
populations.
In
ongoing
trials
investigators
are
interrogating
efficacy
these
agents
new
indications,
including
metabolic
liver
disease,
peripheral
artery
Parkinson
Alzheimer
disease.
success
GLP-1–based
medicines
has
spurred
molecular
entities
combinations
with
unique
pharmacokinetic
pharmacodynamic
profiles,
exemplified
tirzepatide,
a
GIP-GLP-1
coagonist.
Simultaneously,
investigational
molecules
such
as
maritide
block
GIP
activate
GLP-1
receptor,
whereas
retatrutide
survodutide
enable
simultaneous
activation
glucagon
receptors.
Here
I
highlight
evidence
medicines,
while
discussing
that
inform
safety,
focusing
on
muscle
strength,
bone
density
fractures,
exercise
capacity,
gastrointestinal
motility,
retained
gastric
contents
anesthesia,
pancreatic
biliary
tract
disorders,
risk
cancer.
Rapid
progress
highly
efficacious
anticipated
differentiation
newer
subsets
will
provide
greater
opportunities
use
personalized
medicine
approaches
to
improve
health
people
living
cardiometabolic
disorders.
European Heart Journal,
Journal Year:
2024,
Volume and Issue:
unknown
Published: Aug. 30, 2024
The
global
prevalence
of
obesity
has
more
than
doubled
over
the
past
four
decades,
currently
affecting
a
billion
individuals.
Beyond
its
recognition
as
high-risk
condition
that
is
causally
linked
to
many
chronic
illnesses,
been
declared
disease
per
se
results
in
impaired
quality
life
and
reduced
expectancy.
Notably,
two-thirds
obesity-related
excess
mortality
attributable
cardiovascular
disease.
Despite
increasingly
appreciated
link
between
broad
range
manifestations
including
atherosclerotic
disease,
heart
failure,
thromboembolic
arrhythmias,
sudden
cardiac
death,
underrecognized
sub-optimally
addressed
compared
with
other
modifiable
risk
factors.
In
view
major
repercussions
epidemic
on
public
health,
attention
focused
population-based
personalized
approaches
prevent
weight
gain
maintain
healthy
body
from
early
childhood
throughout
adult
life,
well
comprehensive
loss
interventions
for
persons
established
obesity.
This
clinical
consensus
statement
by
European
Society
Cardiology
discusses
current
evidence
epidemiology
aetiology
obesity;
interplay
obesity,
factors
conditions;
management
patients
strategies
lifestyle
changes,
interventional
procedures,
anti-obesity
medications
particular
focus
their
impact
cardiometabolic
outcomes.
document
aims
raise
awareness
factor
provide
guidance
implementing
evidence-based
practices
prevention
optimal
within
context
primary
secondary
prevention.
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.
Journal of the American College of Cardiology,
Journal Year:
2024,
Volume and Issue:
84(1), P. 27 - 40
Published: May 13, 2024
The
glucagon-like
peptide-1
receptor
agonist,
semaglutide,
improved
health
status
and
reduced
body
weight
in
patients
with
obesity-related
heart
failure
(HF)
preserved
ejection
fraction
(HFpEF)
the
STEP-HFpEF
Program.
Whether
benefits
were
due
to
mechanical
unloading
or
effects
on
HF
pathobiology
is
uncertain.
Determine
if
semaglutide
2.4
mg
N-terminal
pro-brain
natriuretic
peptide
(NTproBNP)
HFpEF
compare
treatment
responses
by
baseline
NTproBNP.
Prespecified
secondary
analysis
of
pooled
data
from
two
double-blind,
placebo-controlled,
randomized
trials
(STEP-HFpEF
DM)
testing
HFpEF.
main
outcomes
change
NTproBNP
at
52
weeks
dual
primary
endpoints
KCCQ-CSS
1145
randomized.
Semaglutide,
compared
placebo,
(estimated
ratio
0.82
[95%
CI:
0.74-;
0.91];
P
=
0.0002).
Improvements
more
pronounced
those
higher
vs
lower
difference:
tertile
1:
4.5
points
0.8–8.2],
2:
6.2
2.4–10.0],
3:
11.9
8.1–15.7];
interaction
0.02;
as
a
continuous
variable:
0.004).
Reductions
consistent
across
levels
(interaction
0.21).
In
HFpEF,
Participants
had
similar
degree
loss
but
experienced
larger
reductions
HF-related
symptoms
physical
limitations
than
Journal of the American College of Cardiology,
Journal Year:
2024,
Volume and Issue:
84(17), P. 1587 - 1602
Published: Aug. 30, 2024
Obesity
is
associated
with
adverse
cardiac
remodeling
and
a
key
driver
for
the
development
progression
of
heart
failure
(HF).
Once-weekly
semaglutide
(2.4
mg)
has
been
shown
to
improve
HF-related
symptoms
physical
limitations,
body
weight,
exercise
function
in
patients
obesity-related
preserved
ejection
fraction
(HFpEF),
but
effects
on
structure
this
population
remain
unknown.
Abstract
Obesity
is
a
chronic,
recurring,
progressive
disease
and
major
public
health
problem
associated
with
several
other
diseases
that
lead
to
disability,
morbidity,
mortality.
The
prevalence
of
obesity
has
increased
at
pandemic
levels,
along
increasing
weight-related
comorbidities
deaths
worldwide.
Lifestyle
interventions
alone
provide
clinically
significant
long-term
weight
loss
in
only
small
proportion
individuals,
bariatric
surgery
not
suitable
or
desirable
for
all
patients.
Historically,
anti-obesity
medications
achieved
mean
efficacy
between
5
10%,
which
significantly
impacted
risk
factors,
but
the
average
these
remained
lower
than
expected
by
both
patients
care
professionals
eventually
curbed
use.
Moreover,
there
no
direct
evidence
on
impact
cardiovascular
outcomes.
Semaglutide
newer
medication
changes
overall
landscape,
as
phase
3
studies
show
near
15%
threshold
proportions
greater
20%.
In
this
review,
we
focus
currently
available
medications,
discuss
results
semaglutide,
present
perspectives
future
treatment
after
semaglutide.
