Bonfioli Giovanni Battista, Pagnesi Matteo, Tomasoni Daniela, Rakisheva Amina, Metra Marco
Cardiology, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia Brescia, Italy.
City Cardiology Center Almaty, Kazakhstan.
Card Fail Rev. 2025 Aug 14;11:e19. doi: 10.15420/cfr.2025.10. eCollection 2025.
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), initially developed for glycaemic control in patients with type 2 diabetes, have demonstrated significant cardiometabolic benefits beyond glucose regulation. These agents have multiple effects, including reducing body weight, improving insulin sensitivity, anti-inflammatory properties and enhancing endothelial function. All these mechanisms are potentially beneficial in patients with heart failure (HF), specifically those with HF with preserved left ventricular ejection fraction. Recent trials, including STEP-HFpEF and SUMMIT, underscore the efficacy of GLP-1 RAs in improving quality of life and exercise capacity, as well as possibly reducing major adverse cardiovascular events. Furthermore, these trials demonstrated improvements in other endpoints, such plasma N-terminal pro B-type natriuretic peptide, troponin and C-reactive protein concentrations, consistent with the beneficial effects of GLP-1 RAs on myocardial function and inflammation. Further data are needed regarding the effects of GLP-1 RAs on cardiovascular outcomes, and possibly in a broader range of patients with HF, such as those with HF reduced ejection fraction and/or patients without obesity.
胰高血糖素样肽-1受体激动剂（GLP-1 RAs）最初是为控制2型糖尿病患者的血糖而开发的，现已证明其在血糖调节之外还具有显著的心脏代谢益处。这些药物具有多种作用，包括减轻体重、改善胰岛素敏感性、抗炎特性以及增强内皮功能。所有这些机制对心力衰竭（HF）患者，特别是左心室射血分数保留的HF患者可能有益。最近的试验，包括STEP-HFpEF和SUMMIT试验，强调了GLP-1 RAs在改善生活质量和运动能力方面的疗效，以及可能减少主要不良心血管事件。此外，这些试验还显示其他终点指标有所改善，如血浆N末端B型利钠肽前体、肌钙蛋白和C反应蛋白浓度，这与GLP-1 RAs对心肌功能和炎症的有益作用一致。关于GLP-1 RAs对心血管结局的影响，可能还需要更多数据，并且可能需要在更广泛的HF患者中进行研究，例如射血分数降低的HF患者和/或非肥胖患者。
