Effects of Elamipretide on Left Ventricular Function in Patients With Heart Failure With Reduced Ejection Fraction: The PROGRESS-HF Phase 2 Trial

Jonah Butler, Muhammad Shahzeb Khan, Stefan D. Anker, Gregg C. Fonarow, Raymond J. Kim, Savina Nodari, Christopher M. O'Connor, Burkert Pieske, Elisabeth Pieske-Kraigher, Hani N. Sabbah, Michele Senni, Adriaan A. Voors, James E. Udelson, Jim Carr, Mihai Gheorghiade, Gerasimos Filippatos*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)
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Background: Elamipretide, a novel mitochondrial modulating agent, improves myocardial energetics; however, it is unknown whether this mechanistic benefit translates into improved cardiac structure and function in heart failure (HF) with reduced ejection fraction (HFrEF). The objective of this study was to evaluate the effects of multiple subcutaneous doses of elamipretide on left ventricular end systolic volume (LVESV) as assessed by cardiac magnetic resonance imaging.

Methods: We randomized 71 patients with HFrEF (LVEF

Results: The mean age (standard deviation) of the study population was 65 +/- 10 years, 24% were females, and the mean EF was 31% +/- 7%. The change in LVESV from baseline to week 4 was not significantly different between elamipretide 4 mg (89.4 mL to 85 mL; difference, -4.4 mL) or 40 mg (77.9 mL to 76.6 mL; difference, -1.2 mL) compared with placebo (77.7 mL to 74.6 mL; difference, -3.8 mL) (4 mg vs placebo: difference of means, -0.3; 95% CI, -4.6 to 4.0; P = 0.90; and 40 mg vs placebo: difference of means, 2.3; 95% CI, -1.9 to 6.5; P = 0.28). Also, no significant differences in change in LVESV and LVEF were observed between placebo and either of the elamipretide groups. Rates of any study drugrelated adverse events were similar in the 3 groups.

Conclusions: Elamipretide was well tolerated but did not improve LVESV at 4 weeks in patients with stable HFrEF compared with placebo.

Original languageEnglish
Pages (from-to)429-437
Number of pages9
Issue number5
Publication statusPublished - May-2020


  • Mitochondria
  • elamipretide
  • heart failure
  • cardiac MRI

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