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These can represent the substrates for different cardiovascular diseases, such as atrial fibrillation, coronary artery disease, sudden cardiac death, and heart failure (HF) with both preserved ejection fraction (EF) and reduced EF. Different pathogenetic mechanisms may help to explain the association between obesity and HF including left ventricular remodelling and epicardial fat accumulation, endothelial dysfunction, and coronary microvascular dysfunction. Multi-imaging modalities are required for appropriate recognition of subclinical systolic dysfunction typically associated with obesity, with echocardiography being the most cost-effective technique. Therapeutic approach in patients with obesity and HF is challenging, particularly regarding patients with preserved EF in which few strategies with high level of evidence are available. Weight loss is of extreme importance in patients with obesity and HF, being a primary therapeutic intervention. Sodium\u2013glucose co-transporter-2 inhibitors have been recently introduced as a novel tool in the management of HF patients. The present review aims at analysing the most recent studies supporting pathogenesis, diagnosis, and management in patients with obesity and HF.<\/jats:p>","DOI":"10.1002\/ehf2.14641","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T02:38:58Z","timestamp":1710556738000},"page":"1841-1860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Obesity: The Perfect Storm for Heart Failure"],"prefix":"10.1093","volume":"11","author":[{"given":"Maria","family":"Lembo","sequence":"first","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Strisciuglio","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celeste","family":"Fonderico","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"Mancusi","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Izzo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Trimarco","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Bellis","sequence":"additional","affiliation":[{"name":"Emergenza Accettazione Department, Azienda Ospedaliera \u2018Antonio Cardarelli\u2019 , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Barbato","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sapienza University of Rome , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Morisco","sequence":"additional","affiliation":[{"name":"Department of Advanced Biochemical Sciences, Federico II University , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Speranza","family":"Rubattu","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, Sapienza University of Rome , Rome ,","place":["Italy"]},{"name":"IRCCS Neuromed , Pozzilli ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"2026012113140983000_ehf214641-bib-0001","doi-asserted-by":"publisher","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC). 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