Semaglutide improves symptoms of heart failure
Heart failure is the leading cause of death worldwide. It is classified into 3 subtypes based on the heart’s pumping capacity, called left ventricular ejection fraction (LVEF). LVEF is the percentage of blood that is pumped by the heart's left ventricle to the rest of the body.
Heart failure is the leading cause of death worldwide. It is classified into 3 subtypes based on the heart’s pumping capacity, called left ventricular ejection fraction (LVEF). LVEF is the percentage of blood that is pumped by the heart's left ventricle to the rest of the body. LVEF≤40% is heart failure with reduced ejection fraction; LVEF≥50% is heart failure with preserved ejection fraction (HFpEF), and 41%-49% is heart failure with mildly reduced ejection fraction. HFpEF contributes to at least 50% of heart failure cases. There are various risk factors for HFpEF, such as age, female gender, obesity, diabetes, and hypertension. Obesity is the most common risk factor; about 80% of HFpEF patients are obese. The current medications for HFpEF are not effective for obese patients; thus, there is an imperative need for new drugs to improve patients’ conditions. Body weight reduction by diet management, exercise, or bariatric surgery has been shown to improve HFpEF symptoms. We aim to determine the effect of the weight-loss drug semaglutide (GLP-1 receptor activator) on obese patients with HFpEF.
A multicenter phase 3 clinical trial was conducted worldwide on 529 obese HFpEF patients. These patients were either given 2.4 mg of semaglutide (n=263) or a placebo (n=266) by weekly injections for 52 weeks. The dose of semaglutide or placebo was increased in a stepwise manner in the first 16 weeks, followed by a constant dose of 2.4 mg till 52 weeks. After one year of semaglutide, HFpEF symptoms improved by 90%, and body weight was reduced by 10.9%. It also improved exercise capability by 17 times, overall health by 1.7 times, and reduced the body’s inflammation by 65% compared to placebo. Interestingly, fewer side effects were observed with semaglutide than with placebo. Moreover, the percentage of improvement is far better than that of existing drugs, none of which improved exercise ability. Overall, this study demonstrates the use of semaglutide in improving HFpEF symptoms, with weight loss ultimately leading to better health quality for obese HFpEF patients.