Pivotal Role of Excess Intra-Abdominal Adipose in the Pathogenesis of Metabolic/Obese HFpEF
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The presence of visceral adiposity is associated with increased inflammation, left ventricular hypertrophy, insulin resistance, diastolic and systolic left ventricular dysfunction, and arterial, skeletal muscle, and physical dysfunction.
“The presence of visceral adiposity is associated with increased inflammation, left ventricular hypertrophy, insulin resistance, and diastolic and systolic left ventricular dysfunction, as well as with arterial, skeletal muscle, and physical dysfunction. 7”
From Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (2023) · cites this paper as [7]
In the main text (page unavailable), the paper describes visceral adipose tissue as pro-inflammatory and says it impairs insulin sensitivity. It also links visceral adiposity to exercise intolerance and impaired diastolic function, but attributes systolic, arterial, skeletal-muscle, and physical dysfunction to excess adipose tissue more broadly. The copy does not establish the claimed association with left ventricular hypertrophy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEpidemiologic data indicate that the majority of patients with heart failure with preserved ejection fraction have obesity.
“epidemiologic data indicate that the majority of patients with heart failure with preserved ejection fraction have obesity”
From Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (2023) · cites this paper as [7]
The main text says that more than 80% of US HFpEF patients are overweight or obese, but it does not give a majority figure for obesity alone. It also reports abdominal obesity in 73% of TOPCAT participants, which does not establish the claim for HFpEF patients generally. (LLM, conf=0.85)
Experimental — accuracy not yet measuredObesity, diabetes, and HF result in pro-inflammatory states, and each are risk factors for infectious disease complications.
“Obesity, diabetes, and HF result in pro-inflammatory states, 7,31-34 and each are risk factors for infectious disease complications, an important cause of morbidity and mortality in these patient groups.”
From Semaglutide versus placebo in people with obesity-related heart failure with preserved ejection fraction: a pooled analysis of the STEP-HFpEF and STEP-HFpEF DM randomised trials (2024) · cites this paper as [33]
In the main text (page not provided), the paper says excess adipose tissue promotes inflammation and that inflammatory biomarkers are elevated in HFpEF. It does not establish that diabetes is itself pro-inflammatory or extend the HFpEF finding to all heart failure. The citation appears after the pro-inflammatory-states clause, so the later claim about infectious complications is not assessed here. (LLM, conf=0.85)
Experimental — accuracy not yet measuredObesity and excess adiposity may play a role in the development and progression of heart failure with preserved ejection fraction.
“growing evidence suggests that obesity and excess adiposity are not simply coexisting conditions but may play a role in the development and progression of heart failure with preserved ejection fraction. 4-8”
From Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (2023) · cites this paper as [7]
Growing evidence suggests that adipose tissue may play a pivotal role in the development, progression, and adverse outcomes of heart failure with preserved ejection fraction.
“growing evidence suggests that adipose tissue may play a pivotal role in the development, progression, and adverse outcomes of heart failure with preserved ejection fraction. 4-8”
From Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity (2023) · cites this paper as [7]
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Cites
A Novel Paradigm for Heart Failure With Preserved Ejection Fraction
Paulus, W. J., & Tschöpe, C. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.02.092 · Cited by 3,564 · see citing works
Kitzman, D. W., Brubaker, P., Morgan, T., Haykowsky, M., Hundley, G., Kraus, W. E., Eggebeen, J., & Nicklas, B. J. (2016) · JAMA · doi:10.1001/jama.2015.17346 · Cited by 921 · see citing works
Self-citationThe Association of Obesity and Cardiometabolic Traits With Incident HFpEF and HFrEF
Savji, N., Meijers, W. C., Bartz, T. M., Bhambhani, V., Cushman, M., Nayor, M., Kizer, J. R., Sarma, A., Blaha, M. J., Gansevoort, R. T., et al. (2018) · JACC: Heart Failure · doi:10.1016/j.jchf.2018.05.018 · Cited by 499 · see citing works
Inflammatory Markers and Incident Heart Failure Risk in Older Adults
Kalogeropoulos, A., Georgiopoulou, V., Psaty, B. M., Rodondi, N., Smith, A. L., Harrison, D. G., Liu, Y., Hoffmann, U., Bauer, D. C., Newman, A. B., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.12.045 · Cited by 478 · see citing works
Lee, M., Pramyothin, P., Karastergiou, K., & Fried, S. K. (2013) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2013.05.029 · Cited by 380 · see citing works
Adiposity and Incident Heart Failure and its Subtypes
Rao, V. N., Zhao, D., Allison, M., Güallar, E., Sharma, K., Criqui, M. H., Cushman, M., Blumenthal, R. S., & Michos, E. D. (2018) · JACC Heart Failure · doi:10.1016/j.jchf.2018.07.009 · Cited by 202 · see citing works
Haykowsky, M. J., Nicklas, B. J., Brubaker, P. H., Hundley, W. G., Brinkley, T. E., Upadhya, B., Becton, J. T., Nelson, M. D., Chen, H., & Kitzman, D. W. (2018) · JACC: Heart Failure · doi:10.1016/j.jchf.2018.06.002 · Cited by 179 · see citing works
Self-citationObese Heart Failure With Preserved Ejection Fraction Phenotype
Kitzman, D. W., & Lam, C. S. P. (2017) · Circulation · doi:10.1161/circulationaha.117.028365 · Cited by 87 · see citing works
Self-citationInflammation in Heart Failure With Preserved Ejection Fraction
Gomberg-Maitland, M., Shah, S. J., & Guazzi, M. (2016) · JACC Heart Failure · doi:10.1016/j.jchf.2015.11.013 · Cited by 38 · see citing works
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Semaglutide in Patients with Heart Failure with Preserved Ejection Fraction and Obesity
Kosiborod, M. N., Abildstrøm, S. Z., Borlaug, B. A., Butler, J., Rasmussen, S., Davies, M., Hovingh, G. K., Kitzman, D. W., Lindegaard, M. L., Møller, D. V., et al. (2023) · New England Journal of Medicine · doi:10.1056/nejmoa2306963 · Cited by 1,669 · see citing works
Self-citationSemaglutide in Patients with Obesity-Related Heart Failure and Type 2 Diabetes
Kosiborod, M. N., Petrie, M. C., Borlaug, B. A., Butler, J., Davies, M. J., Hovingh, G. K., Kitzman, D. W., Møller, D. V., Treppendahl, M. B., Verma, S., et al. (2024) · New England Journal of Medicine · doi:10.1056/nejmoa2313917 · Cited by 758 · see citing works
Self-citationBorlaug, B. A., Jensen, M. D., Kitzman, D. W., Lam, C. S. P., Obokata, M., & Rider, O. J. (2023) · Cardiovascular Research · doi:10.1093/cvr/cvac120 · Cited by 450 · see citing works
Self-citationButler, J., Shah, S. J., Petrie, M. C., Borlaug, B. A., Abildstrøm, S. Z., Davies, M. J., Hovingh, G. K., Kitzman, D. W., Møller, D. V., Verma, S., et al. (2024) · The Lancet · doi:10.1016/s0140-6736(24)00469-0 · Cited by 386 · see citing works
Self-citationMyocardial Gene Expression Signatures in Human Heart Failure With Preserved Ejection Fraction
Hahn, V. S., Knutsdottir, H., Luo, X., Bedi, K., Margulies, K. B., Haldar, S. M., Stolina, M., Yin, J., Khakoo, A. Y., Vaishnav, J., et al. (2021) · Circulation · doi:10.1161/circulationaha.120.050498 · Cited by 291 · see citing works
Patel, K. V., Bahnson, J. L., Gaussoin, S. A., Johnson, K. C., Pi-Sunyer, X., White, U., Olson, K. L., Bertoni, A. G., Kitzman, D. W., Berry, J. D., et al. (2020) · Circulation · doi:10.1161/circulationaha.120.050941 · Cited by 69 · see citing works
Self-citation
- Authors
- Kitzman, D. W., & Nicklas, B. J.
- Affiliations
- Wake Forest University Health Sciences (US)
- Corresponding author
- Kitzman, Dalane W.
- Venue
- JACC: Heart Failure
- Publisher
- Elsevier BV
- Published
- 2018-12
- Volume
- 6
- Issue
- 12
- Pages
- 1008-1010
- ISSN
- 2213-1779 (ISSN-L)
- PMC
- PMC7710134
- OpenAlex
- W2896464427
- Cited by
- 67
- References
- 9
- Citations by year
- 2026: 8 · 2025: 24 · 2024: 13 · 2023: 5 · 2022: 6 · 2021: 3 · 2020: 4 · 2019: 4
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5r01ag051624-05)
- National Institute on Aging (R01-AG051624, R01AG018915, R01AG045551, R37AG018915, P30AG021332)
- National Heart, Lung, and Blood Institute (R01HL107257)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- intra-abdominal adipose tissue, visceral fat, heart failure with preserved ejection fraction, obesity, pathogenesis, adipokines
- MeSH terms
- Heart Failure, Humans, Obesity, Stroke Volume, Adiposity, Atherosclerosis
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