HealthRX.com · Printable question sheet
HFpEF and tirzepatide: cardiology visit sheet
Fill in your heart-failure details before an off-label discussion, keep a weekly weight, swelling and diuretic record once treatment starts, and take the SUMMIT and regulatory facts with the questions that decide whether it fits you.
Your heart-failure details
Ejection fraction and date of the echo
BMI now
Main symptoms and how far you can walk
Hospital stays or urgent visits for heart failure in the past year
Diuretic name and dose
Other heart-failure medicinesSGLT2 inhibitor, MRA, others
What SUMMIT and the regulators found
- SUMMIT enrolled people with an ejection fraction of at least 50% and a BMI of at least 30.[1]
- Cardiovascular death or worsening heart failure: 9.9% on tirzepatide versus 15.3% on placebo.[1]
- Cardiovascular deaths were 2.2% versus 1.4% (8 versus 5 people), with a wide confidence interval.[1]
- 6.3% stopped the drug for adverse events, mainly stomach and bowel effects, versus 1.4% on placebo.[1]
- The US Zepbound label lists weight reduction and obstructive sleep apnea, not heart failure.[2]
- The EMA did not recommend a separate heart-failure indication; the SUMMIT data go into the EU prescribing information instead.[3]
Questions for the cardiologist
- Is my ejection fraction in the range SUMMIT studied?
- Would I qualify under the label's weight indication on its own?
- How will my diuretic be adjusted as my weight comes down?
- Who checks my kidney function and fluid balance if I get vomiting or diarrhea?
- Which measure, such as symptoms or a walk test, will we use to judge whether it is helping?
- What happens to coverage if the prescription is written for heart failure rather than weight?
Weekly heart-failure and dose record
| Date | Tirzepatide dose (mg) | Morning weight | Ankle swelling | Breathlessness | Diuretic dose | Notes |
|---|---|---|---|---|---|---|
Call the same day
- Vomiting or diarrhea that stops you keeping fluids down: fluid loss can cause kidney problems.[2]
Sources for the facts on this sheet
- Packer M, Zile MR, Kramer CM, et al. Tirzepatide for Heart Failure with Preserved Ejection Fraction and Obesity. N Engl J Med 2025. PMID 39555826. https://pubmed.ncbi.nlm.nih.gov/39555826/
- Eli Lilly and Company, via DailyMed. Zepbound (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. Effective 2026-08-28. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
- European Medicines Agency. Outcome of assessment on use of Mounjaro in treatment of heart failure with preserved ejection fraction in adults with obesity. Accessed 2026-10-18. https://www.ema.europa.eu/en/documents/medicine-qa/questions-answers-outcome-assessment-use-mounjaro-treatment-heart-failure-preserved-ejection-fraction-adults-obesity_en.pdf
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.