Beyond Weight Loss: the Emerging Role of Incretin-Based Treatments in Cardiometabolic HFpEF.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Opinion in Cardiology Pub Date : 2024-05-01 Epub Date: 2024-01-31 DOI:10.1097/HCO.0000000000001117

Federico Capone, Natasha Nambiar, Gabriele G Schiattarella

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Abstract

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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超越减肥：基于胰岛素的治疗在心脏代谢性高频低血钾症中的新作用。

综述目的：胰岛素类药物是强效的降体重药物，是治疗肥胖相关表型射血分数保留型心力衰竭（HFpEF）的潜在突破性疗法。在这篇综述文章中，我们将讨论体重减轻作为胰岛素类药物对肥胖型 HFpEF 患者的部分益处。此外，我们还将介绍胰高血糖素样肽-1（GLP-1）和葡萄糖依赖性促胰岛素多肽（GIP）受体激动剂对心脏的潜在影响，尤其是与 HFpEF 病理生理学相关的影响：在 STEP-HFpEF 试验中，GLP-1 受体激动剂semaglutide 显著改善了肥胖 HFpEF 患者的生活质量。目前尚不清楚塞马鲁肽对肥胖 HFpEF 患者的益处是否仅仅是减轻体重的结果。考虑到肥胖 HFpEF 患者可采用其他减肥策略（如限制热量、运动训练、减肥手术），回答这个问题对于为这些患者提供量身定制的治疗方案至关重要。考虑到有其他减轻体重的策略可供选择，而且这些策略可能是这些患者的潜在替代选择，因此阐明减轻体重对使用这些药物所观察到的总体益处的贡献对于肥胖 HFpEF 患者的管理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Cardiology 医学-心血管系统

CiteScore

4.20

自引率

4.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Opinion in Cardiology is a bimonthly publication offering a unique and wide ranging perspective on the key developments in the field. Each issue features hand-picked review articles from our team of expert editors. With fourteen disciplines published across the year – including arrhythmias, molecular genetics, HDL cholesterol and clinical trials – every issue also contains annotated reference detailing the merits of the most important papers.