In this JACC Deep Dive, Dr. Harlan Krumholz discusses a pre-specified analysis from the SUMMIT trial, which evaluated the effects of tirzepatide in patients with heart failure with preserved ejection fraction (HFpEF) and obesity, both with and without type 2 diabetes. The study found that tirzepatide significantly improved symptoms, function, and reduced heart failure events, with similar benefits regardless of diabetes status, though weight loss was slightly less in those with diabetes. Importantly, cardiac structural improvements (LV mass and pericardial fat regression) were also similar across both groups, suggesting benefits beyond weight loss alone. The trial's strengths included its integrated design and imaging substudy, though limitations such as modest imaging power and baseline group differences were noted. Clinically, the results support using tirzepatide in HFpEF patients with obesity, regardless of diabetes status, as the benefits remain robust.

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