Abstract Body (Do not enter title and authors here): Introduction:
Obesity-related heart failure in patients is often associated with high symptom burden. However, no treatments have been proven to specifically target obesity-related heart failure with preserved ejection fraction (HfpEF).

Objective:
The objective of this study is to evaluate the efficacy of semaglutide in patients with obesity and HfpEF.

Methods:
The study was by the PRISMA guidelines. Studies reporting endpoints of semaglutide in patients with obesity and HfpEF were included. The outcomes included percentage weight change and adjudicated heart failure events. Both random and common effects models were used for the data analysis. The random intercept logistic regression model was used to compute the proportions, and the Peto method was used to compute the odds ratios. A p-value ≤ 0.05 was considered significant.

Results:
In total, three studies with 1463 patients with obesity and HfpEF were included in the study. The mean age of the patients was 68.8 ± 3.47 years. 50.7% of the patients were females. Patients who received Semaglutide had statistically higher odds of 10% weight reduction (OR 6.35; 1.54-26.21; p<0.00001) and 15% weight reduction (OR 9.44; 2.91-30.60; p<0.0001) when compared to placebo. Additionally, patients who received Semaglutide had lower odds of adjudicated heart failure event (OR 0.32; 0.15-0.67; p=0.35) when compared to patients on placebo.

Conclusion:
Our study demonstrates that semaglutide is significantly effective in reducing weight and potentially lowering the risk of heart failure events. This suggests that semaglutide could be a promising therapeutic option for managing obesity-related HfpEF. However, we need large-scale studies to confirm these benefits.