Key result
Incretin-based treatments improve quality of life and exercise capacity in obese patients with HFpEF, though it remains unclear if these benefits are independent of weight loss.
Why the study?
Whether the beneficial effects of incretin-based medications in obese patients with HFpEF are solely due to weight reduction or involve direct cardiac effects is unclear.
Do incretin-based treatments provide benefits beyond weight loss in obese patients with HFpEF?
Do incretin-based treatments provide benefits beyond weight loss in obese patients with HFpEF?
Incretin-based therapies represent a potential milestone for treating obesity-related HFpEF, though the exact mechanisms of their cardiovascular benefits (weight loss vs. direct effects) require further elucidation.
May support incretin-based drugs for QoL in obese HFpEF; leaves open direct cardiac effects beyond weight loss.
PURPOSE OF REVIEW: Incretin-based drugs are potent weight-lowering agents, emerging as potential breakthrough therapy for the treatment of obesity-related phenotype of heart failure with preserved ejection fraction (HFpEF). In this review article, we will discuss the contribution of weight loss as part of the benefits of incretin-based medications in obese patients with HFpEF. Furthermore, we will describe the potential effects of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists on the heart, particularly in relation to HFpEF pathophysiology. RECENT FINDINGS: In the STEP-HFpEF trial, the GLP-1 receptor agonist semaglutide significantly improved quality of life outcomes in obese HFpEF patients. Whether the beneficial effects of semaglutide in obese patients with HFpEF are merely a consequence of body weight reduction is unclear. Considering the availability of other weight loss strategies (e.g., caloric restriction, exercise training, bariatric surgery) to be used in obese HFpEF patients, answering this question is crucial to provide tailored therapeutic options in these subjects. SUMMARY: Incretin-based drugs may represent a milestone in the treatment of obesity in HFpEF. Elucidating the contribution of weight loss in the overall benefit observed with these drugs is critical in the management of obese HFpEF patients, considering that other weight-lowering strategies are available and might represent potential alternative options for these patients.
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Capone et al. (2024) conducted a review in Cardiometabolic Heart Failure with Preserved Ejection Fraction (HFpEF). Incretin-based treatments (GLP-1 and GIP receptor agonists) was evaluated. Incretin-based treatments improve quality of life and exercise capacity in obese patients with HFpEF, though it remains unclear if these benefits are independent of weight loss.
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