Hormonal
In Heart Failure with Reduced Ejection Fraction (HFrEF), NuSH therapies show promise in reducing cardiovascular mortality and MACE, but require cautious patient selection and monitoring due to potential chronotropic effects (increased heart rate) and arrhythmia risks observed with earlier generation agents.
For heart failure with reduced ejection fraction (HFrEF), NuSH therapies are not yet a standard first-line treatment due to safety concerns like increased heart rate. However, recent real-world data suggests they may significantly reduce mortality in stable patients. If your doctor considers this, ensure you are clinically stable, have a normal resting heart rate, and are monitored closely. It is crucial to combine this therapy with resistance training and high protein intake to prevent muscle loss, which can be a side effect of rapid weight loss.
Conversely, we navigate the uncertainty surrounding heart failure with reduced ejection fraction (HFrEF), where historical safety signals regarding chronotropic effects and arrhythmias necessitate a cautious, precision-based approach.
Why this rating
Based on real-world registry data (SwedeHF) and post-hoc analyses of SELECT, but limited by lack of dedicated large-scale HFrEF RCTs for newer agents.
Source
Nutrient-Stimulated Hormone Therapies in Heart Failure: Targeting Cardiometabolic Burden Beyond Weight Reduction
Dong‐Hyuk Cho · International Journal of Heart Failure · 2026
DOI 10.36628/ijhf.2026.0002
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