Effects of semaglutide on cardiac structure and function in heart failure with preserved ejection fraction and obesity: a pre-specified cardiac magnetic resonance substudy of the CAMEO-SEMA trial
Primary result · Change in left atrial (LA) reservoir strainResult — go to the resultDifference +5.7 % 95% CI +0.3 to +9.7Authors' conclusion
The results of this CMR substudy indicate that in patients with obesity-related HFpEF, semaglutide improves LA function and LV diastolic filling dynamics, identifying improvements in myocardial function that may contribute to semaglutide's improvement of hemodynamics.
Study context
- Population
- Participants with obesity-related heart failure with preserved ejection fraction (HFpEF) who underwent CMR at baseline and 52 weeks, within 1 day of invasive exercise hemodynamic assessment28 female, underwent CMR at baseline and 52 weeks
- Participants
- 49 participants
- Comparison
- Semaglutide compared with placebo
- SEMAGLUTIDEn = 33
- PLACEBOn = 16
Primary result
Change in left atrial (LA) reservoir strain · 52 weeks
Difference
+5.7 %
95% CI +0.3 to +9.7
P = 0.037
As reported in the abstract
Further findings
| Outcome | Difference (s-1) (95% CI) | P value |
|---|---|---|
| LV filling dynamics: early filling rate indexed to end-diastolic volume (eFR/EDV)Improved with semaglutide · prespecified CMR endpoint | +0.64 (+0.42 to +1.00) | P < 0.0001 |
Association of improvements in left atrial (LA) reservoir strain and LV filling dynamics with reductions in exercise pulmonary artery wedge pressure (PAWP)
- LA reservoir strain vs exercise PAWP, r
- r=−0.46, P<0.001
- LV filling dynamics vs exercise PAWP, r
- r=−0.65, P<0.0001
Other prespecified CMR endpoints
- Semaglutide reduced LV mass, restored more physiologic LV geometry, and improved right ventricular function and biventricular myocardial mechanics
Original publication
Effects of semaglutide on cardiac structure and function in heart failure with preserved ejection fraction and obesity: a pre-specified cardiac magnetic resonance substudy of the CAMEO-SEMA trial. Nat Med. Published 8 November 2026. doi:10.
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