What Exactly Is Cardiometabolic HFpEF: A Phenotype or an Endotype?

nutrients stroke volume W hen heart failure with preserved ejection fraction (HFpEF) was first described as a syndrome in the 1980s, it was envisioned as a hypertrophic disorder caused by uncontrolled hypertension.However, coincident with the global epidemic of obesity, we have witnessed a global epidemic of HFpEF.Currently, among patients in clinical trials of HFpEF, 50% to 60% have a body mass index 30 kg/m 2 , and >90% have central obesity, as reflected by a waist-to-height ratio of 0.5. 1 These estimates are impressive, since many large-scale trials specifically excluded patients with a body mass index >45 to 50 kg/m 2 .