Hemodynamic effects of semaglutide in individuals with heart failure with preserved ejection fraction and obesity: a placebo-controlled randomized clinical trial
Primary result · Change in invasively measured pulmonary artery wedge pressure (PAWP) during low-intensity exerciseResult — go to the resultEstimated difference −10.6 mmHg 95% CI −13.3 to −8.0Authors' conclusion
The results from this trial indicate that, in patients with HFpEF and obesity, treatment with semaglutide reduced left heart filling pressures during exercise and at rest and was associated with hemodynamic HFpEF remission in over half of treated patients.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) and obesityrandomly assigned (47 women)
- Participants
- 81 patients
- Comparison
- Semaglutide vs placebo for 52 weeks
- Primary endpoint
- Change in invasively measured pulmonary artery wedge pressure (PAWP) during low-intensity exercise
- Follow-up
- 52 weeks
Methodological detailsrandomized
- Randomized
Primary result
As reported in the abstract
Estimated difference
−10.6 mmHg
95% CI −13.3 to −8.0
P < 0.0001
Change by group
SEMAGLUTIDE
−9.8
mean change · 95% CI −11.3–-8.2 · mmHg
PLACEBO
+0.9
mean change · 95% CI −1.3–3.0 · mmHg
SEMAGLUTIDEvs PLACEBO
estimated difference −10.6 mmHg (95% CI −13.3 to −8.0); P < 0.0001
Further findings
| Outcome | Estimated difference (mmHg) (95% CI) | P value | |
|---|---|---|---|
| Resting PAWPSemaglutide decreased resting PAWP as compared to placebo | −7.1 (−9.8 to −4.4) | P < 0.0001 | |
| −10−505Difference, mmHg (linear scale) |
| Outcome | SEMAGLUTIDE | PLACEBO | Odds ratio for hemodynamic remission (95% CI) | P value | |
|---|---|---|---|---|---|
| Hemodynamic HFpEF remission (normal PAWP at rest and exercise at 52 weeks) | 53.7% | 7.4% | 14.1 (3.0–134.6) | P < 0.001 | |
| 0.050.21520Odds ratio for hemodynamic remission (log scale) |
Baseline pulmonary artery wedge pressure (PAWP)
- PAWP at rest
- 17.5 ± 4.3 mmHg
- PAWP during exercise
- 31.7 ± 5.2 mmHg
Original publication
Hemodynamic effects of semaglutide in individuals with heart failure with preserved ejection fraction and obesity: a placebo-controlled randomized clinical trial. Nat Med. Published 8 November 2026. doi:10.
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