Abstract
Cardiologists play a key role in the identification and subsequent management of patients with cardiovascular disease and comorbid obesity. In addition to the overall cardiovascular risk profile one must also consider the residual cardiovascular risk in patients in whom, despite properly treated comorbidities, dyslipidemia and hypertension), in connection with ongoing obesity, the chronic inflammatory process of the vascular wall continues, and myocardial fibrosis and the HFpEF phenotype develop. Since last year, it has also been able to indicate modern pharmacotherapy such as GLP-1 receptor agonists (RA) and SGLT2 inhibitors for indications other than DM2T. GLP-1 receptor agonists, specifically liraglutide, regulates appetite by increasing the feeling of satiety while simultaneously reducing the feeling of hunger and the desire to consume more food. This leads to significant weight loss and subsequent reduction in the risk of hypertension, arrhythmias (including atrial fibrillation), ischemic heart disease and heart failure. It can be expected that this type of treatment for patients with the HFpEF phenotype and obesity will gain significant traction in the near future. In this case liraglutid application led to signiffcant weight reduction. This enabled reduction in the extent of pharmacotherapy especially extreme reduction of daily insulin burden dosage together with dramatic decrease blood glucose levels near to normal values. The most probable explanation for this impressive improvement is the insulin resistance reduction together with weight reduction. This was accompanied with improvement of the patient’s quality of life, especially of effort dyspnoe reduction and with the renal function improvement too.