{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T07:27:37Z","timestamp":1789457257194,"version":"build-2803163510"},"reference-count":45,"publisher":"Elsevier BV","issue":"8","license":[{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2018,8,1]],"date-time":"2018-08-01T00:00:00Z","timestamp":1533081600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T00:00:00Z","timestamp":1564704000000},"content-version":"vor","delay-in-days":366,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["JACC: Heart Failure"],"published-print":{"date-parts":[[2018,8]]},"DOI":"10.1016\/j.jchf.2018.06.002","type":"journal-article","created":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T14:39:06Z","timestamp":1531319946000},"page":"640-649","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":152,"title":["Regional Adipose Distribution and its Relationship to Exercise Intolerance in Older Obese Patients Who Have Heart Failure With Preserved Ejection Fraction"],"prefix":"10.1016","volume":"6","author":[{"given":"Mark J.","family":"Haykowsky","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Nicklas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Brubaker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Gregory","family":"Hundley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina E.","family":"Brinkley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharathi","family":"Upadhya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Thomas","family":"Becton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Nelson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiying","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalane W.","family":"Kitzman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jchf.2018.06.002_bib1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1056\/NEJMoa052256","article-title":"Trends in prevalence and outcome of heart failure with preserved ejection fraction","volume":"355","author":"Owan","year":"2006","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.jchf.2018.06.002_bib2","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1001\/jama.288.17.2144","article-title":"Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure","volume":"288","author":"Kitzman","year":"2002","journal-title":"JAMA"},{"key":"10.1016\/j.jchf.2018.06.002_bib3","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1093\/gerona\/glt011","article-title":"Impaired aerobic capacity and physical functional performance in older heart failure patients with preserved ejection fraction: role of lean body mass","volume":"68","author":"Haykowsky","year":"2013","journal-title":"J\u00a0Gerontol A Biol Sci Med Sci"},{"key":"10.1016\/j.jchf.2018.06.002_bib4","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/j.amjcard.2013.12.031","article-title":"Skeletal muscle composition and its relation to exercise intolerance in older patients with heart failure and preserved ejection fraction","volume":"113","author":"Haykowsky","year":"2014","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib5","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1093\/eurjhf\/hfr133","article-title":"Abnormal haemodynamic response to exercise in heart failure with preserved ejection fraction","volume":"13","author":"Bhella","year":"2011","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib6","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1161\/CIRCHEARTFAILURE.114.001825","article-title":"Mechanisms of exercise intolerance in heart failure with preserved ejection fraction: the role of abnormal peripheral oxygen extraction","volume":"8","author":"Dhakal","year":"2015","journal-title":"Circ Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib7","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1152\/japplphysiol.00049.2015","article-title":"Determinants of exercise intolerance in patients with heart failure and reduced or preserved ejection fraction","volume":"119","author":"Haykowsky","year":"2015","journal-title":"J\u00a0Appl Physiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib8","first-page":"636","article-title":"Skeletal muscle mitochondrial content, oxidative capacity, and Mfn2 expression are reduced in older patients with heart failure and preserved ejection fraction and are related to exercise intolerance","volume":"4","author":"Molina","year":"2016","journal-title":"J\u00a0Am Coll Cardiol HF"},{"key":"10.1016\/j.jchf.2018.06.002_bib9","doi-asserted-by":"crossref","first-page":"H1364","DOI":"10.1152\/ajpheart.00004.2014","article-title":"Skeletal muscle abnormalities and exercise intolerance in older patients with heart failure and preserved ejection fraction","volume":"306","author":"Kitzman","year":"2014","journal-title":"Am J Physiol Heart Circ Physiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib10","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\u00a0Engl J Med"},{"key":"10.1016\/j.jchf.2018.06.002_bib11","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1161\/CIRCHEARTFAILURE.110.959890","article-title":"Body mass index and adverse cardiovascular outcomes in heart failure patients with preserved ejection fraction: results from the I-PRESERVE trial","volume":"4","author":"Haass","year":"2011","journal-title":"Circ Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib12","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jacc.2016.05.019","article-title":"The HFpEF obesity phenotype: the elephant in the room","volume":"68","author":"Kitzman","year":"2016","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib13","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/jama.2015.17346","article-title":"Effect of caloric restriction or aerobic exercise training on peak oxygen consumption and quality of life in obese older patients with heart failure with preserved ejection fraction: a randomized clinical trial","volume":"315","author":"Kitzman","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.jchf.2018.06.002_bib14","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1161\/CIRCULATIONAHA.116.021884","article-title":"Phenotype-specific treatment of heart failure with preserved ejection fraction: a multiorgan roadmap","volume":"134","author":"Shah","year":"2016","journal-title":"Circulation"},{"key":"10.1016\/j.jchf.2018.06.002_bib15","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1161\/CIRCULATIONAHA.116.026807","article-title":"Evidence supporting the existence of a distinct obese phenotype of heart failure with preserved ejection fraction","volume":"136","author":"Obokata","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.jchf.2018.06.002_bib16","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1161\/CIRCULATIONAHA.117.028365","article-title":"Obese heart failure with preserved ejection phenotype: from pariah to central player","volume":"136","author":"Kitzman","year":"2017","journal-title":"Circulation"},{"key":"10.1016\/j.jchf.2018.06.002_bib17","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/j.1440-1843.2001.00290.x","article-title":"Influence of body fat distribution on oxygen uptake and pulmonary performance in morbidly obese females during exercise","volume":"6","author":"Li","year":"2001","journal-title":"Respirology"},{"key":"10.1016\/j.jchf.2018.06.002_bib18","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00592-013-0519-1","article-title":"Relationships between cardiorespiratory fitness, metabolic control, and fat distribution in type 2 diabetes subjects","volume":"51","author":"Bacchi","year":"2014","journal-title":"Acta Diabetol"},{"key":"10.1016\/j.jchf.2018.06.002_bib19","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/0735-1097(92)90094-4","article-title":"Prevalence and mortality rate of congestive heart failure in the United States","volume":"20","author":"Schocken","year":"1992","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib20","doi-asserted-by":"crossref","first-page":"1190","DOI":"10.1056\/NEJM199511023331806","article-title":"A\u00a0multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure","volume":"333","author":"Rich","year":"1995","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.jchf.2018.06.002_bib21","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1161\/CIRCHEARTFAILURE.110.958785","article-title":"Exercise training in older patients with heart failure and preserved ejection fraction: a randomized, controlled, single-blind trial","volume":"3","author":"Kitzman","year":"2010","journal-title":"Circ Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib22","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.jacc.2011.02.055","article-title":"Determinants of exercise intolerance in elderly heart failure patients with preserved ejection fraction","volume":"58","author":"Haykowsky","year":"2011","journal-title":"J\u00a0Am Coll Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib23","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1016\/S0735-1097(01)01447-4","article-title":"Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance","volume":"38","author":"Hundley","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib24","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1038\/ijo.2014.29","article-title":"Periaortic fat and cardiovascular risk: a comparison of high-risk older adults and age-matched healthy controls","volume":"38","author":"Brinkley","year":"2014","journal-title":"Int J Obes (Lond)"},{"key":"10.1016\/j.jchf.2018.06.002_bib25","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1016\/j.amjcard.2012.08.015","article-title":"Reliability of peak exercise testing in patients with heart failure with preserved ejection fraction","volume":"110","author":"Scott","year":"2012","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib26","first-page":"919","article-title":"The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure","volume":"132","author":"Guyatt","year":"1985","journal-title":"Can Med Assoc J"},{"key":"10.1016\/j.jchf.2018.06.002_bib27","doi-asserted-by":"crossref","first-page":"M85","DOI":"10.1093\/geronj\/49.2.M85","article-title":"A\u00a0short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission","volume":"49","author":"Guralnik","year":"1994","journal-title":"J\u00a0Gerontol"},{"key":"10.1016\/j.jchf.2018.06.002_bib28","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1056\/NEJM199503023320902","article-title":"Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability","volume":"332","author":"Guralnik","year":"1995","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.jchf.2018.06.002_bib29","doi-asserted-by":"crossref","first-page":"M192","DOI":"10.1093\/gerona\/55.4.M192","article-title":"Association of muscle power with functional status in community-dwelling elderly women","volume":"55","author":"Foldvari","year":"2000","journal-title":"J\u00a0Gerontol A Biol Sci Med Sci"},{"key":"10.1016\/j.jchf.2018.06.002_bib30","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1161\/CIRCIMAGING.113.000532","article-title":"Relation of regional fat distribution to left ventricular structure and function","volume":"6","author":"Neeland","year":"2013","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jchf.2018.06.002_bib31","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/j.ijcard.2014.08.108","article-title":"Visceral adiposity and skeletal muscle mass are independently and synergistically associated with left ventricular structure and function: the Korean genome and epidemiology study","volume":"176","author":"Park","year":"2014","journal-title":"Int J Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib32","doi-asserted-by":"crossref","first-page":"E002978","DOI":"10.1161\/CIRCHEARTFAILURE.115.002978","article-title":"Association of weight and body composition on cardiac structure and function in the ARIC study atherosclerosis risk in communities","volume":"9","author":"Bello","year":"2016","journal-title":"Circ Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib33","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1016\/j.amjcard.2004.06.075","article-title":"Relation between epicardial adipose tissue and left ventricular mass","volume":"94","author":"Iacobellis","year":"2004","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib34","doi-asserted-by":"crossref","first-page":"e004396","DOI":"10.1161\/CIRCIMAGING.115.004396","article-title":"Association of central adiposity with adverse cardiac mechanics: findings from the hypertension genetic epidemiology network study","volume":"9","author":"Selvaraj","year":"2016","journal-title":"Circ Cardiovasc Imaging"},{"key":"10.1016\/j.jchf.2018.06.002_bib35","doi-asserted-by":"crossref","first-page":"e004129","DOI":"10.1161\/CIRCHEARTFAILURE.117.004129","article-title":"Fatigability, exercise intolerance, and abnormal skeletal muscle energetics in heart failure","volume":"10","author":"Weiss","year":"2017","journal-title":"Circ Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib36","doi-asserted-by":"crossref","first-page":"e004281","DOI":"10.1161\/CIRCHEARTFAILURE.117.004281","article-title":"Making the case for skeletal muscle myopathy and its contribution to exercise intolerance in heart failure with preserved ejection fraction","volume":"10","author":"Kitzman","year":"2017","journal-title":"Circ Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib37","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/s40608-015-0070-4","article-title":"Relationships between mitochondrial content and bioenergetics with obesity, body composition and fat distribution in healthy older adults","volume":"2","author":"Bharadwaj","year":"2015","journal-title":"BMC Obes"},{"key":"10.1016\/j.jchf.2018.06.002_bib38","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1002\/ejhf.239","article-title":"Heart failure with preserved ejection fraction induces molecular, mitochondrial, histological, and functional alterations in rat respiratory and limb skeletal muscle","volume":"17","author":"Bowen","year":"2015","journal-title":"Eur J Heart Fail"},{"key":"10.1016\/j.jchf.2018.06.002_bib39","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1532-429X-12-40","article-title":"Epicardial adipose tissue in patients with heart failure","volume":"12","author":"Doesch","year":"2010","journal-title":"J\u00a0Cardiovasc Magn Reson"},{"key":"10.1016\/j.jchf.2018.06.002_bib40","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.amjcard.2011.03.058","article-title":"Epicardial fat volume in patients with left ventricular systolic dysfunction","volume":"108","author":"Khawaja","year":"2011","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib41","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/1532-429X-11-15","article-title":"Validation of cardiovascular magnetic resonance assessment of pericardial adipose tissue volume","volume":"11","author":"Nelson","year":"2009","journal-title":"J\u00a0Cardiovasc Magn Reson"},{"key":"10.1016\/j.jchf.2018.06.002_bib42","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1016\/j.echo.2011.06.013","article-title":"Pericardial rather than epicardial fat is a cardiometabolic risk marker: an MRI vs echo study","volume":"24","author":"Sicari","year":"2011","journal-title":"J\u00a0Am Soc Echocardiogr"},{"key":"10.1016\/j.jchf.2018.06.002_bib43","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1038\/oby.2007.591","article-title":"Volumetric assessment of epicardial adipose tissue with cardiovascular magnetic resonance imaging","volume":"15","author":"Fluchter","year":"2007","journal-title":"Obesity (Silver Spring)"},{"key":"10.1016\/j.jchf.2018.06.002_bib44","doi-asserted-by":"crossref","first-page":"3907","DOI":"10.1113\/JP273049","article-title":"The role of epicardial adipose tissue in cardiac biology: classic concepts and emerging roles","volume":"595","author":"Antonopoulos","year":"2017","journal-title":"J\u00a0Physiol"},{"key":"10.1016\/j.jchf.2018.06.002_bib45","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1016\/j.bbadis.2016.07.020","article-title":"Acetylation control of cardiac fatty acid beta-oxidation and energy metabolism in obesity, diabetes, and heart failure","volume":"1862","author":"Fukushima","year":"2016","journal-title":"Biochim Biophys Acta"}],"container-title":["JACC: Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213177918304499?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2213177918304499?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T04:49:54Z","timestamp":1761972594000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2213177918304499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8]]},"references-count":45,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["S2213177918304499"],"URL":"https:\/\/doi.org\/10.1016\/j.jchf.2018.06.002","relation":{},"ISSN":["2213-1779"],"issn-type":[{"value":"2213-1779","type":"print"}],"subject":[],"published":{"date-parts":[[2018,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Regional Adipose Distribution and its Relationship to Exercise Intolerance in Older Obese Patients Who Have Heart Failure With Preserved Ejection Fraction","name":"articletitle","label":"Article Title"},{"value":"JACC: Heart Failure","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jchf.2018.06.002","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 by the American College of Cardiology Foundation. Published by Elsevier.","name":"copyright","label":"Copyright"}]}}