Heart failure & cardiomyopathiesRandomised controlled trial
SERCA2a Agonist Effects on Cardiac Performance During Exercise in Heart Failure With Preserved Ejection Fraction
- Randomised crossover trial
- single-blind
- placebo-controlled
Authors' conclusion
Low-dose istaroxime had no effect on cardiac filling pressure or parameters of relaxation in patients with HFpEF during exercise.
Study context
- Population
- Patients with heart failure with preserved ejection fraction (HFpEF) and control subjects performing upright cycle exercise with right-sided heart catheterization11 controls, 15 HFpEF
- Comparison
- Istaroxime vs saline placebo during exercise
Primary result
As reported in the abstract
Resting and exercise hemodynamic and diastolic measures (cardiac output, PCWP, diastolic function)
- Istaroxime 0.5 μg/kg/min had no effect on resting or exercise measures in HFpEF or controls
Further findings
| Outcome | Values | Δ (mm Hg) | P value |
|---|---|---|---|
| PCWP during exercise, HFpEF vs controls | HFpEF 25 ± 10 mm Hg · Controls 12 ± 5 mm Hg | P < 0.001 | |
| Increase in Ees, controls vs HFpEF · driven by lower ESV | Controls Δ 1.55 ± 0.99 mm Hg/mL · HFpEF Δ 0.86 ± 1.31 mm Hg/mL | P = 0.03 | |
| Exercise PCWP with istaroxime 1.0 μg/kg/min vs placebo (exploratory, 7 HFpEF) · slightly lower; Hedge's g = 0.30 · exploratory analysis | 2.2 |
Exercise pulmonary capillary wedge pressure (PCWP) with istaroxime 1.0 μg/kg/min vs placebo (exploratory, 7 HFpEF)
- No effects on diastolic function; increases in systolic blood pressure (SBP) and s' (mild inotropic effect)
Original publication
SERCA2a Agonist Effects on Cardiac Performance During Exercise in Heart Failure With Preserved Ejection Fraction. JACC Heart Fail. Published 19 April 2023. doi:10.1016/j.jchf.2023.02.006
Summarised from the published abstract; every number is checked against it