Time to screen: rationale and roadmap for HFpEF screening in individuals with obesity

Collaborators GRF (2020) Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet 396(10258):1223–1249

Article  Google Scholar 

Kenchaiah S, Evans JC, Levy D et al (2002) Obesity and the risk of heart failure. N Engl J Med 347(5):305–313

Article  PubMed  Google Scholar 

Suthahar N, Meems LMG, Withaar C et al (2022) Relative fat mass, a new index of adiposity, is strongly associated with incident heart failure: data from PREVEND. Sci Rep 12(1):147

Article  PubMed  PubMed Central  CAS  Google Scholar 

Obokata M, Reddy YNV, Pislaru SV et al (2017) Evidence supporting the existence of a distinct obese phenotype of heart failure with preserved ejection fraction. Circulation 136(1):6–19

Article  PubMed  PubMed Central  CAS  Google Scholar 

Ho JE, Lyass A, Lee DS et al (2013) Predictors of new-onset heart failure: differences in preserved versus reduced ejection fraction. Circ Heart Fail 6(2):279–86

Article  PubMed  Google Scholar 

Tromp J, Claggett BL, Liu J et al (2021) Global differences in heart failure with preserved ejection fraction: the PARAGON-HF Trial. Circ Heart Fail 14(4):e007901

Article  PubMed  CAS  Google Scholar 

Chockalingam A (2022) “Obesity-Years” burden may predict reversibility in heart failure with preserved ejection fraction. Front Cardiovasc Med 9:821829

Article  PubMed  PubMed Central  Google Scholar 

Reddy YNV, Lewis GD, Shah SJ et al (2019) Characterization of the obese phenotype of heart failure with preserved ejection fraction: a RELAX trial ancillary study. Mayo Clin Proc 94(7):1199–1209

Article  PubMed  Google Scholar 

Iacobellis G, Corradi D, Sharma AM (2005) Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart. Nat Clin Pract Cardiovasc Med 2(10):536–543

Article  PubMed  Google Scholar 

Adeva-Andany MM, Domínguez-Montero A, Adeva-Contreras L et al (2024) Body fat distribution contributes to defining the relationship between insulin resistance and obesity in human diseases. Curr Diabetes Rev 20(5):e160823219824

Article  PubMed  CAS  Google Scholar 

Zain S, Shamshad T, Kabir A et al (2023) Epicardial adipose tissue and development of atrial fibrillation (AFIB) and heart failure with preserved ejection fraction (HFpEF). Cureus 15(9):e46153

PubMed  PubMed Central  Google Scholar 

Esser N, L’Homme L, De Roover A et al (2013) Obesity phenotype is related to NLRP3 inflammasome activity and immunological profile of visceral adipose tissue. Diabetologia 56(11):2487–2497

Article  PubMed  CAS  Google Scholar 

Porreca E, Di Febbo C, Fusco L et al (2004) Soluble thrombomodulin and vascular adhesion molecule-1 are associated to leptin plasma levels in obese women. Atherosclerosis 172(1):175–180

Article  PubMed  CAS  Google Scholar 

Verboven K, Wouters K, Gaens K et al (2018) Abdominal subcutaneous and visceral adipocyte size, lipolysis and inflammation relate to insulin resistance in male obese humans. Sci Rep 8(1):4677

Article  PubMed  PubMed Central  CAS  Google Scholar 

Zeller M, Steg PG, Ravisy J et al (2008) Relation between body mass index, waist circumference, and death after acute myocardial infarction. Circulation 118(5):482–490

Article  PubMed  Google Scholar 

Bodenstab ML, Varghese RT, Iacobellis G (2024) Cardio-lipotoxicity of epicardial adipose tissue. Biomolecules 14(11)

Borlaug BA, Jensen MD, Kitzman DW et al (2023) Obesity and heart failure with preserved ejection fraction: new insights and pathophysiological targets. Cardiovasc Res 118(18):3434–3450

Article  PubMed  Google Scholar 

Packer M (2018) Epicardial adipose tissue may mediate deleterious effects of obesity and inflammation on the myocardium. J Am Coll Cardiol 71(20):2360–2372

Article  PubMed  CAS  Google Scholar 

Weerts J, Mourmans SGJ, Barandiarán Aizpurua A, et al (2022) The role of systemic microvascular dysfunction in heart failure with preserved ejection fraction. Biomolecules 12(2)

Wang W, Gao Y, Wang J et al (2024) Prognostic value of epicardial adipose tissue in heart failure with mid-range and preserved ejection fraction: a multicenter study. J Am Heart Assoc 13(24):e036789

Article  PubMed  PubMed Central  Google Scholar 

McDonagh TA, Metra M, Adamo M et al (2023) 2023 focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 44(37):3627–3639

Article  PubMed  CAS  Google Scholar 

Marx N, Federici M, Schütt K et al (2023) 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes: developed by the task force on the management of cardiovascular disease in patients with diabetes of the European Society of Cardiology (ESC). Eur Heart J 44(39):4043–4140

Article  PubMed  CAS  Google Scholar 

Ndumele CE, Neeland IJ, Tuttle KR et al (2023) A synopsis of the evidence for the science and clinical management of cardiovascular-kidney-metabolic (CKM) syndrome: a scientific statement from the American Heart Association. Circulation 148(20):1636–1664

Article  PubMed  Google Scholar 

Reddy YNV, Carter RE, Sundaram V et al (2024) An evidence-based screening tool for heart failure with preserved ejection fraction: the HFpEF-ABA score. Nat Med 30(8):2258–2264

Article  PubMed  CAS  Google Scholar 

Kosyakovsky LB, Liu EE, Wang JK et al (2024) Uncovering unrecognized heart failure with preserved ejection fraction among individuals with obesity and dyspnea. Circ Heart Fail 17(5):e011366

Article  PubMed  PubMed Central  CAS  Google Scholar 

Bernhardt V, Babb TG (2016) Exertional dyspnoea in obesity. Eur Respir Rev 25(142):487–495

Article  PubMed  PubMed Central  Google Scholar 

van Dalen BM, Chin JF, Motiram PA et al (2025) Challenges in the diagnosis of heart failure with preserved ejection fraction in individuals with obesity. Cardiovasc Diabetol 24(1):71

Article  PubMed  PubMed Central  Google Scholar 

Todd M (2009) Managing chronic oedema in the morbidly obese patient. Br J Nurs 18(18):1120–4

Article  PubMed  Google Scholar 

Wearing SC, Hennig EM, Byrne NM et al (2006) Musculoskeletal disorders associated with obesity: a biomechanical perspective. Obes Rev 7(3):239–250

Article  PubMed  CAS  Google Scholar 

Daniels LB, Clopton P, Bhalla V et al (2006) How obesity affects the cut-points for B-type natriuretic peptide in the diagnosis of acute heart failure. Results from the Breathing Not Properly Multinational Study. Am Heart J. 151(5):999–1005

Article  PubMed  CAS  Google Scholar 

Verbrugge FH, Omote K, Reddy YNV et al (2022) Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality. Eur Heart J 43(20):1941–1951

Article  PubMed  PubMed Central  CAS  Google Scholar 

Obokata M, Kane GC, Reddy YN et al (2017) Role of diastolic stress testing in the evaluation for heart failure with preserved ejection fraction: a simultaneous invasive-echocardiographic study. Circulation 135(9):825–838

Article  PubMed  Google Scholar 

Reddy YNV, Tada A, Obokata M et al (2025) Evidence-based application of natriuretic peptides in the evaluation of chronic heart failure with preserved ejection fraction in the ambulatory outpatient setting. Circulation 151(14):976–989

Article  PubMed  CAS  Google Scholar 

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