{"id":140003,"date":"2026-11-13T18:36:49","date_gmt":"2026-11-13T23:36:49","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=140003"},"modified":"2026-11-13T18:36:49","modified_gmt":"2026-11-13T23:36:49","slug":"helios-b-exercise-substudy-vutrisiran-helped-preserve-exercise-capacity-in-attr-cardiomyopathy","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=140003","title":{"rendered":"HELIOS-B Exercise Substudy: Vutrisiran Helped Preserve Exercise Capacity in ATTR Cardiomyopathy"},"content":{"rendered":"\n<ul class=\"wp-block-list\">\n<li>Peak oxygen uptake held steady over 2 years with vutrisiran and fell with placebo in patients with ATTR cardiomyopathy.<\/li>\n\n\n\n<li>The difference was 1.6 mL\/kg\/min in favor of vutrisiran.<\/li>\n\n\n\n<li>Patients on vutrisiran also breathed more efficiently during exercise and reached a higher peak heart rate.<\/li>\n<\/ul>\n\n\n\n<p>Transthyretin amyloid cardiomyopathy (ATTR-CM) slowly takes away patients&#8217; ability to exercise. In the phase 3 HELIOS-B trial, vutrisiran lowered the risk of death and recurrent cardiovascular events and slowed the decline in 6-minute walk distance compared with placebo. Less is known about how treatments like vutrisiran affect the heart and lungs during exercise.<\/p>\n\n\n\n<p>In a late-breaking presentation at the American Heart Association 2026 Scientific Sessions, Dr. Brinda Thillainathan of the National Amyloidosis Centre at the Royal Free Hospital in London presented an analysis of HELIOS-B patients (<a href=\"https:\/\/clinicaltrials.gov\/study\/NCT04153149\">NCT04153149<\/a>) treated at that center. HELIOS-B randomized 655 patients with ATTR-CM to vutrisiran 25 mg, an injection given every 3 months, or placebo. At the National Amyloidosis Centre, patients also had cardiopulmonary exercise testing (CPET) combined with a stress echocardiogram as part of routine follow-up. In this test, patients pedal a bike while their breathing, oxygen use, and heart function are measured.<\/p>\n\n\n\n<p>The analysis included 48 patients, 25 on vutrisiran and 23 on placebo, who had a baseline test and at least one follow-up test at 1 or 2 years. None were taking other disease-modifying treatments for ATTR-CM. Median age was in the late 70s, nearly all patients were men, and most had mild symptoms.<\/p>\n\n\n\n<p>The main finding was in peak oxygen uptake (VO<sub>2<\/sub>), the most oxygen the body can use at full effort. Over 2 years, peak VO<sub>2<\/sub> stayed close to baseline with vutrisiran and fell with placebo, a difference of 1.6 mL\/kg\/min (95% CI 0.1\u20133.0; <em>P<\/em>=0.031). The maximum workload patients reached on the bike did not differ significantly between groups.<\/p>\n\n\n\n<p>Vutrisiran also helped patients breathe more efficiently. The VE\/VCO\u2082 slope, a measure of ventilatory efficiency, increased with placebo and decreased with vutrisiran (between-group difference, \u22126.4; 95% CI, \u221210.2 to \u22122.6; <em>P<\/em>=0.001)<strong>. <\/strong>Patients on vutrisiran also reached a higher peak heart rate, 7.5 percentage points more of their predicted maximum (<em>P<\/em>=0.023).<\/p>\n\n\n\n<p>The stress echocardiogram findings did not differ significantly between groups. At peak exercise, the right ventricle contracted better with vutrisiran, with a 5.7 mm difference in tricuspid annular plane systolic excursion (TAPSE) compared with placebo (95% CI 1.7\u20139.7; <em>P<\/em>=0.006). Measures of how well the left ventricle fills and relaxes also favored vutrisiran. Stroke volume, cardiac output, and pulmonary artery pressure did not differ between groups.<\/p>\n\n\n\n<p>This was a small, single-center analysis done after the trial, and the investigators noted possible selection bias. By 2 years, 17 patients remained in each group, and 4 patients on placebo had died. While HELIOS-B showed that vutrisiran lowers the risk of death and cardiovascular events in ATTR-CM, the investigators see CPET imaging as a useful way to track whether therapies like it are working.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Transthyretin amyloid cardiomyopathy (ATTR-CM) slowly takes away patients&#8217; ability to exercise. In the phase 3 HELIOS-B trial, vutrisiran lowered the risk of death and recurrent cardiovascular events and slowed the decline in 6-minute walk distance compared with placebo. Less is known about how treatments like vutrisiran affect the heart and lungs during exercise. In a [&hellip;]<\/p>\n","protected":false},"author":40617,"featured_media":140004,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"aside","meta":{"footnotes":"","_ppma_block_editor_authors":""},"categories":[1093,8],"tags":[1096,47,185],"tmauthors":[],"ppma_author":[1071],"class_list":{"0":"post-140003","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-aha-2026","8":"category-news","9":"tag-aha-2026","10":"tag-featured","11":"tag-news","12":"post_format-post-format-aside","13":"author-joseph-nasr-md"},"authors":[{"term_id":1071,"user_id":40617,"is_guest":0,"slug":"joseph-nasr-md","display_name":"Joseph Nasr","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/530a343d3e08798e23303e3dcee6bf2f19a4e0175dee36ab2ec2fe9681868aa3?s=96&r=g","avatar_alt":"","avatar_decorative":"","author_category":"1","first_name":"Joseph","last_name":"Nasr","user_url":"","job_title":"Research Fellow, Baim Institute for Clinical Research","description":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/140003","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40617"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=140003"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/140003\/revisions"}],"predecessor-version":[{"id":140005,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/140003\/revisions\/140005"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/140004"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=140003"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=140003"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=140003"},{"taxonomy":"tmauthors","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftmauthors&post=140003"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=140003"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}