Pulmonary artery pressure trajectories in heart failure patients treated with GLP‐1 receptor agonists

Abstract Aims Data support favourable haemodynamic benefits of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) on improving cardiac structural abnormalities and function in patients with heart failure (HF). However, the direct haemodynamic effects of GLP‐1 RAs remain inadequately characterized...

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Main Authors: Haoran Jiang, Phuuwadith Wattanachayakul, Veraprapas Kittipibul, Erika Nicolsen, Todd McVeigh, Oksana Kamneva, Marat Fudim
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:ESC Heart Failure
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Online Access:https://doi.org/10.1002/ehf2.15308
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Summary:Abstract Aims Data support favourable haemodynamic benefits of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) on improving cardiac structural abnormalities and function in patients with heart failure (HF). However, the direct haemodynamic effects of GLP‐1 RAs remain inadequately characterized. We aim to investigate temporal trends of pulmonary artery pressure (PAP) in HF patients receiving GLP‐1 RAs. Methods and results In this single‐centre retrospective cohort study, we identified HF patients with a CardioMEMS device who received semaglutide or tirzepatide for at least 6 months during the monitoring period. Patients who were already on GLP‐1 RAs prior to device implantation were excluded. The relationship between weight change and PAPs was assessed using Pearson correlation. A total of nine patients were included (54 years, BMI 41.4 kg/m2, 67% men, 44% with EF < 40%, 89% diabetes, 89% semaglutide). Median dose of semaglutide (or equivalent) at 6 months was 0.9 (range 0.25–1) mg/week. Body weight significantly decreased from 123.6 to 117.2 kg (P = 0.047), while guideline‐directed medical therapy (GDMT) and loop diuretic uses and dosages remained unchanged. Significant reductions were observed in systolic PAP (38.9 to 34.0 mmHg, P = 0.045), diastolic PAP (20.0 to 17.8 mmHg, P = 0.019) and mean PAP (27.3 to 24.3 mmHg, P = 0.018). There was a significant correlation between weight loss and reductions in systolic PAP (r = 0.69, P = 0.04) and mean PAP (r = 0.72, P = 0.029). Conclusions GLP1‐RA use in HF patients was significantly associated with reductions in body weight and PAPs at 6 months, despite no changes in GDMT and loop diuretic doses.
ISSN:2055-5822