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Abstract
Incretin-based therapies could significantly improve heart failure symptoms and induce weight loss in obese patients with heart failure with preserved ejection fraction (HFpEF).
- Bariatric surgery leads to the most substantial and lasting weight loss but has not been evaluated in randomized trials specifically for HFpEF outcomes.
- Recent trials show that glucagon-like peptide-1 receptor agonists and dual receptor agonists can alleviate symptoms and slow heart failure progression in obese HFpEF patients, regardless of diabetes.
- Sodium-glucose cotransporter-2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists may provide prognostic advantages in HFpEF, especially for individuals with higher body mass index (BMI).
- Angiotensin receptor-neprilysin inhibitors and the controlled metabolic accelerator HU6 currently lack randomized trial support for their use in this population.
- A combination of incretin-based therapies, SGLT2 inhibitors, and non-steroidal MRAs may be the most effective strategy available for managing obesity-related HFpEF.
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