Over time, the heart can become stiff which can lead to a type of heart failure, heart failure with preserved function (HFPEF). Currently, there is no known treatment beyond the use of diuretics (water pills) to help symptoms. The lack of treatment is in contrast to patients who have heart failure with reduced ejection fraction, where many excellent life prolonging treatments are widely available. Sadly, these treatments are largely ineffective in HFPEF. A number of medical conditions are associated with HFPEF including diabetes mellitus, hypertension and excess weight – all these conditions cause inflammation which seems to accelerate the aging process within the heart. Therefore control of blood pressure and sugar delays are important. Weight loss is encouraged, but in reality, it can be difficult to lose and maintain weight loss.
A new approach is causing interest in the heart failure community. Semaglutide is a medication which is used to treat diabetes mellitus, and is associated with significant weight loss (15 to 25%). A trial is underway exploring whether significant weight loss in patients with HFPEF who are overweight (body mass index greater than 30 kg/m2) improves the patient’s condition. As of April 2021 the STEP-HF trial (https://www.clinicaltrialsregister.eu/ctr-search/trial/2019-004452-11/HU) is enrolling participants at the Great Western Hospital (https://www.gwh.nhs.uk/wards-and-services/a-to-z/research-and-innovation/ Tel 01793 605152), including patients with and without diabetes mellitus.