Cardiac failure reviewSep 23, 2024

How Glucagon-like Peptide-1 Receptor Agonists May Affect Heart Function, Exercise Ability, and Quality of Life

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jan 20, 2026

Abstract

Glucagon-like peptide-1 receptor agonists may have effects on surrogate heart failure outcomes.

GLP-1 receptor agonists are primarily used for glucose control in diabetes and obesity.
Emerging evidence suggests potential cardiovascular benefits of GLP-1 RAs beyond glycaemic control.
Previous cardiovascular studies on similar agents indicate possible positive outcomes in heart failure management.
Current investigations into GLP-1 RAs in heart failure populations have produced inconclusive results.
Reported effects on cardiac structure, function, exercise capacity, and in heart failure patients are variable.

Simplified

Glucagon-like peptide-1 (GLP-1) receptor agonists (RAs) are emerging glucose-lowering agents primarily used in managing diabetes and obesity. Recently, GLP-1 RAs have garnered attention for their cardiovascular benefits beyond glycaemic control in patients with type 2 diabetes, exhibiting patterns previously seen in cardiovascular outcomes trials on sodium-glucose cotransporter 2 inhibitors, which now receive a high level of recommendation for the treatment of heart failure (HF). GLP-1 RAs have been increasingly investigated in HF cohorts, but mainly in small-scale studies reporting inconclusive findings regarding clinical outcomes and different safety profiles in HF patients with reduced and preserved ejection fractions. This review discusses the effects of GLP-1 RAs on surrogate HF outcomes, such as cardiac structure and function, exercise capacity and , in HF patients across the spectrum of left ventricular ejection fraction, to provide insights into the potential of these agents to be investigated in large clinical trials to evaluate clinical outcomes.

Key numbers

-10.7%

Weight Reduction

Estimated difference in weight reduction compared to placebo in the STEP HFpEF trial.

20.3 m

Improvement in 6MWT Distance

Estimated difference in 6-minute walk test distance compared to placebo in the STEP HFpEF trial.

7.8 points

KCCQ Clinical Summary Score Improvement

Difference in Kansas City Cardiomyopathy Questionnaire scores compared to placebo in the STEP HFpEF trial.

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Funding

Competing interests

Disclosure: AR reports receiving speaker fees from Novartis, Roche Diagnostics and AstraZeneca, and is on the Cardiac Failure Review editorial board; this did not influence peer review. A Soloveva has received grants from the European Society of Cardiology and support from AstraZeneca, Bayer, Novartis and Servier. All other authors have no conflicts of interest to declare.

PubMed

How Glucagon-like Peptide-1 Receptor Agonists May Affect Heart Function, Exercise Ability, and Quality of Life

Abstract

Key numbers

Full Text

Funding

Competing interests

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Abstract

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Funding

Competing interests

Related papers

You found one interesting study. We’ll send the next 7.

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