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Clinical Implications The STEP-HFpEF trial program, which includes STEP-HFpEF (in patients with HFpEF and obesity) and STEP-HFpEF DM (in patients with HFpEF, obesity, and T2DM) demonstrated significant benefits of weekly subcutaneous semaglutide 2.4 mg, improving physical function, alleviating symptoms, and promoting weight loss with potential disease-modifying effects.(12,13) The dual primary endpoints of change in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS ) and percentage weight loss at 52 weeks drove the positive results of the trials

(ii) the degree to which herpesvirus infection causes oxidative stress varies among herpesviruses (strain-related stress hypothesis)

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Current evidence from large cardiovascular outcome trials provides reassurance that this modest chronotropic effect does not translate into increased cardiovascular risk for most patients