heart failure

1. MODERATOR
DR NARUTTAM SONOWAL
(ASSOCIATE PROF.DEPARTMENT OF MEDICINE, JMCH)
PRESENTOR
DR SONU PAUL
(SECOND YEAR POST GRADUATE TRAINEE, MEDICINE, JMCH)

2. HEART
FAILURE

3. DEFINITION
ACC/AHA-2022
Heart failure defined as “a complex
clinical syndrome that results from any
structural or functional impairment of
ventricular filling(diastole) or ejection
blood(systole)”

4. CLASSIFICATION
HFrEF HFmrEF HFimpEF HFpEF
<40% 41-49% >10%imp >50

5. HFpEF
It is a heterogenous syndrome.
Similar functional decline,hospital admission
rates,economic costs as HFrEF.
It is a disease defined by co-morbidities and also
driven by co-morbidities.

6. DIAGNOSIS
Sign and symptoms of HF
EF >50%
Increase in biomarkers
Structural abnormalites in HEART (LVH,LA enlargement)

7. SEMAGLUTIDE
It is a GLP-1 receptor agonist
A linear sequence of 31 amino acids joined together by peptide
linkages

9. ETHICAL CONSIDERATION
 The protocol, consent form and were approved by an
independent ethics committee.
 All participants provided written informed consent.
 The trial was conducted in accordance with principles of the
Declaration of HELSINKI and the good clinical practice
guidelines of the international council of harmonisation.
 FUNDED BY NOVO NORDISK.

10. It is a randomized,double –blind,placebo control trial
96 sites in 13 countries( Including INDIA).
Total no of participants 529
Patients were randomly assigned in 1:1 ratio.
METHODS

11. INCLUSION CRITERIA
Adults >=18 years of age
NYHA class II-IV
KCCQ-CSS<90
BMI>30kg/m2
LVEF>50%

12. EXCLUSION CRITERIA
 Diabetes
 Gain of >5kg 90days before screening

13. THE TRIAL TREATMENT
The dose of SEMAGLUTIDE was 2.4 mg
Route-SC
Dosing- once weekly for 52 weeks

14. OUTCOMES

15. PRIMARY OUTCOMES
1-The mean change in KCCQ-CSS at week 52
+16.6 points +8.7 points
(SEMAGLUTIDE) (PLACEBO)
2-The mean change in body weight at week 52
-13.3% -2.4%
(SEMAGLUTIDE) (PLACEBO)

18. SECONDARY OUTCOMES
1-Mean change in the 6 minute walk distance at 52
weeks
21.5m 1.2%
(semaglutide) (placebo)
2-Reduction in CRP levels at 52 weeks
43.5% 7.3%
(semaglutide) (placebo)
cont.

19. 3.Percentage reduction in NT-proBNP
-20.9% -5.3%
(semaglutide) (placebo)
4.Hospitalization or urgent visit for heart failure
1event 12 event
(semaglutide) (placebo)

22. ADVERSE EVENTS

23. EVENTS SEMAGLUTIDE PLACEBO
SERIOUS 35 71
EVENTS SEMAGLUTIDE PLACEBO
DEATH 3 4
CARDIAC EVENT 7 43

25. LIMITATION
Small sample size
Short duration Study

26. CONCLUSION
In this randomized, placebo-controlled trial
involving patients with heart failure with
preserved ejection fraction and obesity, once
weekly semaglutide at a dose of 2.4 mg results
in larger reductions in heart failure–related
symptoms and physical limitations

27. TAKE HOME MESSAGE
In patients with heart failure with preserved
ejection fraction and obesity, treatment with
semaglutide (2.4 mg) led to larger reductions
in symptoms and physical limitations, greater
improvements in exercise function, and greater
weight loss than placebo.

28. SIMILAR STUDIES