Heart failure reviews

Viewing obesity-related heart failure with preserved pumping as a disease affecting multiple organs: treatments based on hormone signals and imaging measures

Updated

Abstract

Obesity-related heart failure with preserved ejection fraction (HFpEF) is increasingly recognized as a multiorgan syndrome.

  • Obesity contributes to HFpEF through metabolic dysfunction, systemic inflammation, and increased fat around organs.
  • Higher levels of visceral and epicardial fat are associated with heart, liver, and kidney involvement.
  • GLP-1 receptor agonists may improve symptoms, exercise capacity, and reduce heart failure events in obesity-related HFpEF.
  • Incretin-based therapies could lead to decreased ectopic fat deposits and beneficial changes in heart structure.
  • Future clinical trials are needed to explore the mechanisms of benefit and the role of weight-reduction therapies in this condition.

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Funding

Competing interests

Declarations. Competing interests: Competing interest: MM, AD and CL are employees of Perspectum, a company that develops medical imaging devices. MM also holds a Visiting Professorship at the University of Oxford. The remaining authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper. To minimise institutional bias, all imaging recommendations in this narrative review are based on vendor-neutral, widely adopted CMR, liver MRI and body-composition techniques, and we have cited standard measurement methods where available. No proprietary imaging sequences, software platforms or commercial services from Perspectum or any other vendor are named or promoted in the manuscript.
PubMed

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