Effects of Acute GLP-1 Infusion on Pulmonary and Systemic Hemodynamics in Patients With Heart Failure: A Pilot Study.

Abstract

PURPOSE:

Cardiovascular-safety studies assessing glucagon-like peptide (GLP)-1 receptor agonists and dipeptidyl peptidase 4 inhibitors have provided inconsistent data on the risk for developing heart failure. Animal studies have shown that GLP-1 is a vasodilator; if confirmed in humans, this may ameliorate heart failure symptoms.

METHODS:

In a single-center, observational pilot study, we recruited 10 patients with advanced heart failure undergoing right heart catheterization, and we recorded pulmonary hemodynamic measures, including cardiac output calculated by thermodilution and the indirect Fick method before and after a 15-minute continuous infusion of native GLP-1 (7-36) NH2.

FINDINGS:

There was a neutral effect of GLP-1 on all pressure and hemodynamics indices as derived by cardiac output calculated by thermodilution. However, there was a small but consistent reduction in cardiac output as calculated by the indirect Fick method after GLP-1 infusion (baseline, 4.0 [1.1] L/min vs GLP-1, 3.6 [0.9] L/min; P = 0.003), driven by a consistent reduction in mixed venous oxygen saturation after GLP-1 infusion (baseline, 62.2% [7.0%] vs GLP-1, 59.3% [6.8%]; P < 0.001), whereas arterial saturation remained constant (baseline, 96.8% [3.3%] vs GLP-1, 97.0% [3.2%]; P = 0.34). This resulted in an increase in systemic vascular resistance by Fick (baseline, 1285 [228] dyn · s/cm5 vs GLP-1, 1562 [247] dyn · s/cm5; P = 0.001).

IMPLICATIONS:

Acute infusion of GLP-1 has a neutral hemodynamic effect, when assessed by thermodilution, in patients with heart failure. However, GLP-1 reduces mixed venous oxygen saturation. ClinicalTrials.gov identifier: NCT02129179.

• Authors: Sophie J Clarke, Stephen Pettit, Joel P Giblett, Tian Zhao, Anna C Kydd, Nicolai J W Albrechtsen, Carolyn F Deacon, Jayan Parameshwar, Stephen P Hoole
• Journal: Clinical therapeutics (Clin Ther) Vol. 41 Issue 1 Pg. 118-127.e0 (01 2019) ISSN: 1879-114X [Electronic] United States
• PMID: 30598343 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• Vasodilator Agents
• Glucagon-Like Peptide 1

Topics

• Adult
• Cardiac Output (drug effects)
• Female
• Glucagon-Like Peptide 1 (administration & dosage)
• Heart Failure (drug therapy)
• Hemodynamics (drug effects)
• Humans
• Male
• Middle Aged
• Pilot Projects
• Thermodilution
• Vasodilator Agents (administration & dosage, pharmacology)