Adiposity and clinical outcomes in East Asian patients with heart failure and preserved ejection fraction

Yuko Seki, Masaru Obokata, Tomonari Harada, Kazuki Kagami, Hidemi Sorimachi, Yuki Saito, Toshimitsu Kato, Hideki Ishii

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Background: Despite the obesity paradox, visceral adiposity is associated with poor clinical outcomes in patients with heart failure with preserved ejection fraction (HFpEF). However, it remains unclear whether a relationship between visceral fat and clinical outcomes exists in Asian patients with HFpEF, in whom obesity is rare. Methods: Visceral and subcutaneous adipose tissue (VAT and SAT) volume and area were measured using computed tomography (CT) in 196 HFpEF patients. The primary endpoint was a composite of all-cause mortality or HF hospitalization. Results: Participants had a normal body mass index (BMI) (22.5 ± 4.4 kg/m2), and obesity (BMI > 30 kg/m2) was rare (4.6 %). The primary outcome was observed in 64 patients during a median follow-up of 11.6 months. Lower VAT and SAT volumes were associated with underweight and malnutrition. Composite outcomes increased as body weight, BMI, and height-indexed SAT volume and area decreased. Lower height-indexed VAT volume and area were also associated with the outcomes. The height-indexed SAT area provided independent and incremental prognostic value over age, BMI, blood pressure, and creatinine and albumin levels. Conclusions: In lean East Asian patients with HFpEF, a lower VAT volume was associated with poorer clinical outcomes. CT-based assessments of adiposity may provide incremental prognostic value over simple anthropometric indices in lean HFpEF patients.

Original languageEnglish
Article number101162
JournalIJC Heart and Vasculature
Publication statusPublished - Feb 2023


  • Computed tomography
  • Heart failure
  • Malnutrition
  • Obesity
  • Visceral fat


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