{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:03:49Z","timestamp":1784693029174,"version":"3.55.0"},"reference-count":29,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["ajconline.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The American Journal of Cardiology"],"published-print":{"date-parts":[[2023,11]]},"DOI":"10.1016\/j.amjcard.2023.09.024","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T17:28:41Z","timestamp":1695749321000},"page":"294-301","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"special_numbering":"C","title":["Obesity Paradox in Heart Failure Revisited: Etiology as Effect Modifier"],"prefix":"10.1016","volume":"207","author":[{"given":"Liyan","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengchao","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.amjcard.2023.09.024_bib0001","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa020245","article-title":"Obesity and the risk of heart failure","volume":"347","author":"Kenchaiah","year":"2002","journal-title":"N Engl J Med"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0002","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1016\/j.jchf.2016.09.013","article-title":"Prevalence, profile, and prognosis of severe obesity in contemporary hospitalized heart failure trial populations","volume":"4","author":"Joyce","year":"2016","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0003","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1111\/obr.12707","article-title":"Effects of intentional weight loss in patients with obesity and heart failure: a systematic review","volume":"19","author":"McDowell","year":"2018","journal-title":"Obes Rev"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0004","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1001\/jama.2012.113905","article-title":"Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis","volume":"309","author":"Flegal","year":"2013","journal-title":"JAMA"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0005","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1016\/S0002-9149(03)00031-6","article-title":"Body composition and prognosis in chronic systolic heart failure: the obesity paradox","volume":"91","author":"Lavie","year":"2003","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0006","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1016\/j.jacc.2013.09.072","article-title":"Body mass index and mortality in acutely decompensated heart failure across the world: a global obesity paradox","volume":"63","author":"Shah","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0007","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1016\/j.jchf.2015.06.009","article-title":"The heart failure overweight\/obesity survival paradox: the missing sex link","volume":"3","author":"Vest","year":"2015","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0008","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1002\/ejhf.576","article-title":"No benefit from the obesity paradox for diabetic patients with heart failure","volume":"18","author":"Zamora","year":"2016","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0009","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.jchf.2019.02.015","article-title":"Outcomes and effect of treatment according to etiology in HFrEF: an analysis of PARADIGM-HF","volume":"7","author":"Balmforth","year":"2019","journal-title":"JACC Heart Fail"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0010","first-page":"1650","article-title":"Global variations in heart failure etiology, management, and outcomes [published correction appears in JAMA 2023;330:880]","volume":"329","author":"Joseph","year":"2023","journal-title":"JAMA"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0011","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/j.amjcard.2009.05.059","article-title":"Influence of etiology of heart failure on the obesity paradox","volume":"104","author":"Arena","year":"2009","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0012","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1016\/j.ijcard.2011.11.022","article-title":"The obesity paradox in heart failure: is etiology a key factor?","volume":"166","author":"Zamora","year":"2013","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0013","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1177\/2047487320927610","article-title":"Body mass index and outcomes in ischaemic versus non-ischaemic heart failure across the spectrum of ejection fraction","volume":"28","author":"Gentile","year":"2021","journal-title":"Eur J Prev Cardiol"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0014","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2022.966745","article-title":"Associations of body mass index with mortality in heart failure with preserved ejection fraction patients with ischemic versus non-ischemic etiology","volume":"9","author":"Zeng","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0015","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1056\/NEJM197112232852601","article-title":"The natural history of congestive heart failure: the Framingham study","volume":"285","author":"McKee","year":"1971","journal-title":"N Engl J Med"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0016","first-page":"98","article-title":"[Chinese guidelines for the diagnosis and treatment of heart failure 2014]","volume":"42","year":"2014","journal-title":"Zhonghua Xin Xue Guan Bing Za Zhi"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0017","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1038\/sj.ijo.0802006","article-title":"The effect of sex, age and race on estimating percentage body fat from body mass index: the Heritage Family Study","volume":"26","author":"Jackson","year":"2002","journal-title":"Int J Obes Relat Metab Disord"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0018","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1079\/BJN19910073","article-title":"Body mass index as a measure of body fatness: age- and sex-specific prediction formulas","volume":"65","author":"Deurenberg","year":"1991","journal-title":"Br J Nutr"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0019","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1093\/ajcn\/72.3.694","article-title":"Healthy percentage body fat ranges: an approach for developing guidelines based on body mass index","volume":"72","author":"Gallagher","year":"2000","journal-title":"Am J Clin Nutr"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0020","doi-asserted-by":"crossref","first-page":"383","DOI":"10.2337\/dc11-1334","article-title":"Clinical usefulness of a new equation for estimating body fat","volume":"35","author":"G\u00f3mez-Ambrosi","year":"2012","journal-title":"Diabetes Care"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0021","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/0002-9610(80)90246-9","article-title":"Prognostic nutritional index in gastrointestinal surgery","volume":"139","author":"Buzby","year":"1980","journal-title":"Am J Surg"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0022","first-page":"5","article-title":"[Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population]","volume":"23","author":"Zhou","year":"2002","journal-title":"Zhonghua Liu Xing Bing Xue Za Zhi"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0023","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1161\/CIRCULATIONAHA.107.753483","article-title":"Relation between body mass index, waist circumference, and death after acute myocardial infarction","volume":"118","author":"Zeller","year":"2008","journal-title":"Circulation"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0024","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1016\/j.trsl.2014.05.001","article-title":"Obesity, metabolic dysfunction, and cardiac fibrosis: pathophysiological pathways, molecular mechanisms, and therapeutic opportunities","volume":"164","author":"Cavalera","year":"2014","journal-title":"Transl Res"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0025","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1161\/CIRCULATIONAHA.117.032474","article-title":"Leptin-aldosterone-neprilysin axis: identification of its distinctive role in the pathogenesis of the three phenotypes of heart failure in people with obesity","volume":"137","author":"Packer","year":"2018","journal-title":"Circulation"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0026","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/joim.12728","article-title":"Manifestations and mechanisms of myocardial lipotoxicity in obesity","volume":"284","author":"Sletten","year":"2018","journal-title":"J Intern Med"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0027","first-page":"868","article-title":"Obesity modifies the energetic phenotype of dilated cardiomyopathy","volume":"43","author":"Rayner","year":"2021","journal-title":"Eur Heart J"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0028","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.jacc.2015.12.016","article-title":"Bariatric surgery and emergency department visits and hospitalizations for heart failure exacerbation: population-based, self-controlled series","volume":"67","author":"Shimada","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.amjcard.2023.09.024_bib0029","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/j.cardfail.2019.03.007","article-title":"Nutrition, obesity, and cachexia in patients with heart failure: a consensus statement from the Heart Failure Society of America Scientific Statements Committee","volume":"25","author":"Vest","year":"2019","journal-title":"J Card Fail"}],"container-title":["The American Journal of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002914923009979?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002914923009979?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T06:49:59Z","timestamp":1757573399000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002914923009979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":29,"alternative-id":["S0002914923009979"],"URL":"https:\/\/doi.org\/10.1016\/j.amjcard.2023.09.024","relation":{},"ISSN":["0002-9149"],"issn-type":[{"value":"0002-9149","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Obesity Paradox in Heart Failure Revisited: Etiology as Effect Modifier","name":"articletitle","label":"Article Title"},{"value":"The American Journal of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.amjcard.2023.09.024","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2023 Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}