Semaglutide Improves Myocardial Perfusion and Performance in a Large Animal Model of Coronary Artery Disease.
Publication/Presentation Date
12-12-2024
Abstract
BACKGROUND: Coronary artery disease is the leading cause of death worldwide. It imposes an enormous symptomatic burden on patients, leaving many with residual disease despite optimal procedural therapy and up to one-thirds with debilitating angina amenable neither to procedures, nor to current pharmacological options. Semaglutide (SEM), a GLP-1 (glucagon-like peptide 1) agonist originally approved for management of diabetes, has garnered substantial attention for its capacity to attenuate cardiovascular risk. Although subgroup analyses in patients indicate promise, studies explicitly designed to isolate the impact of SEM on the sequelae of coronary artery disease, independently of comorbid diabetes or obesity, are lacking.
METHODS: Yorkshire swine (n=17) underwent placement of an ameroid constrictor around the left circumflex coronary artery to induce coronary artery disease. Oral SEM was initiated postoperatively at 1.5 mg and scaled up in 2 weeks to 3 mg in treatment animals (n=8) for a total of 5 weeks, while control animals (n=9) received no drug. All then underwent myocardial harvest with acquisition of perfusion and functional data using microsphere injection and pressure-volume loop catheterization. Immunoblotting, immunohistochemistry, and immunofluorescence were performed on the most ischemic myocardial segments for mechanistic elucidation.
RESULTS: SEM animals exhibited improved left ventricular ejection fraction, both at rest and during rapid myocardial pacing (both
CONCLUSIONS: This study reveals the capacity of oral SEM to augment cardiac function in the chronically ischemic heart in a highly translational large animal model, likely through AMPK-mediated improvement in endothelial function and perfusion to the ischemic myocardium.
ISSN
1524-4636
Published In/Presented At
Stone, C. R., Harris, D. D., Broadwin, M., Kanuparthy, M., Nho, J. W., Yalamanchili, K., Hamze, J., Abid, M. R., & Sellke, F. W. (2024). Semaglutide Improves Myocardial Perfusion and Performance in a Large Animal Model of Coronary Artery Disease. Arteriosclerosis, thrombosis, and vascular biology, 10.1161/ATVBAHA.124.321850. Advance online publication. https://doi.org/10.1161/ATVBAHA.124.321850
Disciplines
Medicine and Health Sciences
PubMedID
39665144
Department(s)
Department of Surgery, Fellows and Residents
Document Type
Article