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Targeting the DPP-4-GLP-1 pathway improves exercise tolerance in heart failure patients: a systematic review and

Chengcong Chen1, Ying Huang2, Yongmei Zeng3

  • 1Section of Endocrinology, Department of Pediatrics, Shenzhen Maternity & Child Healthcare Hospital, Shenzhen, China.

BMC Cardiovascular Disorders
|December 25, 2019
PubMed
Abstract

Insights

Dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) can improve exercise tolerance in heart failure patients. These widely used anti-diabetic drugs show promise for managing exercise intolerance in heart failure, particularly in those with type 2 diabetes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Exercise intolerance is a primary symptom of heart failure.
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are common anti-diabetic medications.

Purpose of the Study:

  • To evaluate the efficacy of DPP-4 inhibitors or GLP-1 RAs in improving exercise tolerance in heart failure patients.
  • To assess the impact of these drugs on quality of life, adverse events, and mortality.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Electronic literature search of PubMed, EMBASE, and Cochrane Library up to March 2019.
  • Primary outcome: exercise tolerance (6-min walk test, peak O2 consumption).

Main Results:

  • Four trials (659 patients) met eligibility criteria.
  • DPP-4 inhibitors/GLP-1 RAs significantly improved exercise tolerance (MD 24.88, P=0.01).
  • No significant decrease in quality of life or increase in serious adverse events/mortality observed.

Conclusions:

  • DPP-4 inhibitors or GLP-1 RAs enhance exercise tolerance in heart failure patients.
  • These drugs may be a beneficial option for type 2 diabetes patients with heart failure.
  • The DPP-4-GLP-1 pathway warrants further investigation for exercise intolerance in other conditions.
Keywords:
DPP-4 inhibitorExercise toleranceGLP-1 receptor agonistHeart failure

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