Abstract
Heart failure is not a single disease but a clinical syndrome with symptoms and/or signs caused by a structural/functional cardiac abnormality and represents a public health problem, leading to significant functional impairment, morbidity, and poor quality of life. In 2023, 64 million people had been diagnosed with heart failure and needed specific treatment. An important percentage is associated with diabetes mellitus type 2 (T2DM) as well. Because of the large etiology of this syndrome treatment should be leaded by the cause who underwent to heart failure. A few glucose-lowering therapies showed their efficacy in treating heart failure for patient with or without T2DM such as sodium glucose cotransporter inhibitors (SGLT-2 inhibitors) but the role of Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is still investigated. At this point, evidence show no improvement in heart failure with reduced ejection fraction (HFrEF) treated with GLP-1 RAs but in heart failure with preserved ejection fraction (HFpEF) proves otherwise.