Mirabegron therapy does not prevent progression to Heart Failure: Study

Mirabegron therapy showed no significant impact on left ventricular mass or diastolic function over 12 months in patients with structural heart disease and no or mild heart failure symptoms, a recent study published in JAMA Cardiology has found.

Left ventricular hypertrophy (LVH) is a significant contributor to heart failure (HF) development and progression. For individuals in the pre-HF stage (stage B), there has been a lack of effective treatments to prevent the transition to overt HF (stage C). A new study investigated whether activating β3-adrenergic receptors (β3ARs) using the β3AR agonist mirabegron could be a safe and effective approach to prevent the progression of LVH and diastolic dysfunction in patients with pre- or mild HF.

The Beta3-LVH trial, a prospective, triple-blind, placebo-controlled phase 2b randomized clinical trial, enrolled patients from September 12, 2016, to February 26, 2021, with a 12-month follow-up period. The trial randomized participants (1:1) to receive mirabegron (50 mg/d) or a placebo for 12 months.

Among the 296 enrolled patients, mirabegron had a neutral effect on LV mass and diastolic function over the 12-month study period. The mirabegron group showed a 1.3 g/m2 increase in LV mass index or LVMI and a −0.15 decrease in Doppler velocity ratio compared to the placebo group. Adverse events were reported in both groups, with no deaths occurring during the trial.

This study suggests that mirabegron therapy did not significantly impact LVH or diastolic function in patients with structural heart disease and no or mild HF symptoms.

Reference: Balligand J, Brito D, Brosteanu O, et al. Repurposing the β3-Adrenergic Receptor Agonist Mirabegron in Patients With Structural Cardiac Disease: The Beta3-LVH Phase 2b Randomized Clinical Trial. JAMA Cardiol. Published online September 20, 2023. DOI:10.1001/jamacardio.2023.3003