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Furthermore, the modest chronotropic effects of GLP-1 RAs, attributed to reduced vagal tone [62,63,65] and direct sinoatrial node stimulation [61,122], raise concerns about their use in patients where heart rate control is crucial, particularly in advanced HFrEF
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These effects are greater than those seen with older weight loss medications (typically ~5% total weight loss) and close to typical weight loss seen with bariatric surgery
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