In the CAMEO-SEMA trial, treatment with semaglutide significantly improved cardiac structure, left ventricular filling dynamics, and hemodynamics in patients suffering from obesity-related heart failure with preserved ejection fraction. Cardiac magnetic resonance imaging showed that semaglutide increased left atrial reservoir strain by 5.7 percent and reduced left ventricular mass over 52 weeks. These structural improvements correlated with decreased exertional pulmonary artery wedge pressure.
Hemodynamic endpoints and findings
- ▪In the CAMEO-SEMA trial, semaglutide reduced exertional pulmonary artery wedge pressure in patients with obesity-related heart failure with preserved ejection fraction
- ▪In the CAMEO-SEMA trial, hemodynamic remission was defined as achieving resting pulmonary artery wedge pressure below 15 mm Hg and exercise pressure below 25 mm Hg
CAMEO-SEMA study design and demographics
- ▪Participants in the CAMEO-SEMA cardiac magnetic resonance substudy underwent imaging assessments at baseline and 52 weeks, within one day of invasive exercise hemodynamic testing
- ▪The CAMEO-SEMA trial evaluated the hemodynamic effects of semaglutide in patients with obesity-related heart failure with preserved ejection fraction over a one-year period
- ▪The CAMEO-SEMA cardiac magnetic resonance substudy evaluated 49 participants, including 33 receiving semaglutide and 16 receiving placebo, across 52 weeks of treatment
- ▪The CAMEO-SEMA cardiac magnetic resonance substudy registered under ClinicalTrials.gov number NCT05371496 included 28 female participants among its 49 enrolled subjects
Semaglutide effects on ventricular mechanics
- ▪Treatment with semaglutide reduced left ventricular mass and restored more physiologic left ventricular geometry in patients with obesity-related heart failure with preserved ejection fraction
- ▪In the CAMEO-SEMA cardiac magnetic resonance substudy, semaglutide improved left ventricular early filling rate indexed to end-diastolic volume by 0.64 per second compared with placebo
- ▪In patients with obesity and heart failure with preserved ejection fraction, semaglutide improved right ventricular function and biventricular myocardial mechanics over 52 weeks
Left atrial strain and hemodynamics
- ▪Enhanced left ventricular filling dynamics after semaglutide administration correlated with reductions in exercise pulmonary artery wedge pressure among trial participants
- ▪In a prespecified cardiac magnetic resonance substudy of the CAMEO-SEMA trial, semaglutide improved left atrial reservoir strain by 5.7 percent compared with placebo after 52 weeks of treatment
- ▪Improvements in left atrial reservoir strain following semaglutide treatment were significantly associated with reductions in exercise pulmonary artery wedge pressure in the cardiac magnetic resonance substudy of the CAMEO-SEMA trial
Trial funding and leadership
- ▪The CAMEO-SEMA study of semaglutide was supported by the United States Congressionally Directed Medical Research Programs under award number W81XWH2210245, with study drug provided by Novo Nordisk
- ▪Researcher Barry A. Borlaug conceived and designed the CAMEO-SEMA study and prepared the first draft of the manuscript
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