Cardiology · Endocrinology ·
Semaglutide improved cardiac measures in obesity-related HFpEF substudy
A prespecified cardiac MRI substudy of the randomized CAMEO-SEMA trial included 49 participants with obesity-related heart failure with preserved ejection fraction (HFpEF). At 52 weeks, semaglutide was associated with improvements in left atrial reservoir strain and left ventricular filling dynamics compared with placebo; these changes correlated with reduced exercise pulmonary artery wedge pressure.
- Prespecified CMR substudy included 49 CAMEO-SEMA participants.
- Semaglutide improved left atrial strain versus placebo at 52 weeks.
- Left ventricular filling dynamics also improved.
- Imaging changes correlated with lower exercise wedge pressure.
Glucagon-like peptide-1 receptor agonists have been shown to improve symptoms in people with obesity-related HFpEF. This prespecified cardiac magnetic resonance (CMR) substudy of the randomized CAMEO-SEMA trial examined cardiac structure and function in 49 participants (33 assigned to semaglutide and 16 to placebo; 28 women). CMR was performed at baseline and 52 weeks. The primary CMR endpoint was change in left atrial reservoir strain; left ventricular filling dynamics were also assessed.
Compared with placebo, semaglutide improved left atrial reservoir strain by 5.7% (95% CI, 0.3 to 9.7; P=0.037) and the indexed early filling rate by 0.64 s⁻¹ (95% CI, 0.42 to 1.00; P<0.0001). Changes in these measures were associated with reductions in exercise pulmonary artery wedge pressure. The report also describes lower left ventricular mass, more physiologic left ventricular geometry, and improvements in right ventricular function and biventricular myocardial mechanics.
These findings offer potential mechanistic insight into semaglutide’s hemodynamic effects in obesity-related HFpEF, but come from a small imaging substudy. The results do not establish that the measured CMR changes themselves improve clinical outcomes or support changing treatment practice.
In practice
For patients with obesity-related HFpEF, this small prespecified substudy suggests semaglutide may improve left atrial reservoir strain and left ventricular filling dynamics, alongside previously reported hemodynamic improvements. The 49-participant imaging analysis found these changes correlated with lower exercise pulmonary artery wedge pressure. However, CMR measures are surrogate outcomes, and the study does not show that these structural or functional changes translate into better clinical outcomes or establish a basis for changing treatment decisions.
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Nature Medicine: Effects of semaglutide on cardiac structure and function in heart failure with preserved ejection fraction and obesity: a pre-specified cardiac magnetic resonance substudy of the CAMEO-SEMA trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.