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

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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

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/cm(5) vs GLP-1, 1562 [247] dyn . s/cm(5); P = 0.001). (C) 2018 Elsevier Inc. All rights reserved.
Original languageEnglish
JournalClinical Therapeutics
Volume41
Issue number1
Pages (from-to)118-127
Number of pages10
ISSN0149-2918
DOIs
Publication statusPublished - 2019

    Research areas

  • GLP-1, heart failure, hemodynamics, right heart catheterization

ID: 216927677