{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:53:01Z","timestamp":1791910381138,"version":"4.3.4"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PARADIGM-HF","award":["NCT01035255"],"award-info":[{"award-number":["NCT01035255"]}]},{"name":"ATMOSPHERE","award":["NCT00853658"],"award-info":[{"award-number":["NCT00853658"]}]},{"DOI":"10.13039\/100020604","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100020604","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Experimental evidence suggests that adipose tissue may secrete aldosterone, and mineralocorticoid receptor antagonists (MRAs) appear to be more effective in patients with obesity. Therefore, we examined aldosterone levels according to measures of adiposity in patients with heart failure and reduced ejection fraction (HFrEF) participating in two large trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Aldosterone, N-terminal pro B-type natriuretic peptide (NT-proBNP), and B-type natriuretic peptide (BNP) levels were compared according to body mass index (BMI) categories: normal weight (&amp;lt;25.0 kg\/m2), overweight (25.0\u201329.9 kg\/m2), obesity class I (30.0\u201334.9 kg\/m2), and obesity class II\/III (\u226535.0 kg\/m2). Of the 2201 patients not treated with an MRA, in whom aldosterone levels were measured at baseline in ATMOSPHERE and PARADIGM-HF, the mean age was 67.8 years, and 440 (20.0%) were female. Patients with higher BMI had a higher left ventricular ejection fraction but worse New York Heart Association functional class than those with normal weight. Higher BMI was associated with higher aldosterone levels but lower NT-proBNP and BNP levels (P for trend &amp;lt; 0.001), compared to those with normal weight. This natriuretic peptide trend was also seen for other anthropometric measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Greater adiposity was associated with higher concentrations of aldosterone but lower levels of B-type natriuretic peptides in patients with HFrEF. Adipose tissue may influence the neurohumoral milieu in HFrEF, including the secretion of aldosterone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cvr\/cvaf235","type":"journal-article","created":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T12:54:33Z","timestamp":1763211273000},"page":"14-18","source":"Crossref","is-referenced-by-count":5,"title":["Obesity, aldosterone, and natriuretic peptides in patients with heart failure and reduced ejection fraction"],"prefix":"10.1093","volume":"122","author":[{"given":"Shingo","family":"Matsumoto","sequence":"first","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , 126 University Place, Glasgow, Scotland G12 8TA ,","place":["United Kingdom"]},{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University, Faculty of Medicine , Tokyo 143-8540 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad H","family":"Butt","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , 126 University Place, Glasgow, Scotland G12 8TA ,","place":["United Kingdom"]},{"name":"Department of Cardiology, Copenhagen University Hospital, Rigshospitalet , Copenhagen 2100 ,","place":["Denmark"]},{"name":"Department of Cardiology, Zealand University Hospital , Roskilde 4000 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kieran F","family":"Docherty","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , 126 University Place, Glasgow, Scotland G12 8TA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-5317","authenticated-orcid":false,"given":"Pardeep S","family":"Jhund","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , 126 University Place, Glasgow, Scotland G12 8TA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T","family":"Abraham","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, The Ohio State University , Columbus, OH 43210 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1443-0701","authenticated-orcid":false,"given":"Akshay S","family":"Desai","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital , Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Kober","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Copenhagen University Hospital, Rigshospitalet , Copenhagen 2100 ,","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean L","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Institut de Cardiologie de Montr\u00e9al, Universit\u00e9 de Montr\u00e9al , Montreal, QC H3C 3J7 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-2387","authenticated-orcid":false,"given":"Milton","family":"Packer","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute Baylor, University Medical Center , Dallas, TX 75390 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0885-1953","authenticated-orcid":false,"given":"Muthiah","family":"Vaduganathan","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital , Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital , Boston, MA 02115 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6317-3975","authenticated-orcid":false,"given":"John J V","family":"McMurray","sequence":"additional","affiliation":[{"name":"British Heart Foundation Cardiovascular Research Centre, University of Glasgow , 126 University Place, Glasgow, Scotland G12 8TA ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"2026022323463758300_cvaf235-B1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jacc.2024.10.111","article-title":"Finerenone, obesity, and heart failure with mildly reduced\/preserved ejection fraction: prespecified analysis of FINEARTS-HF","volume":"85","author":"Butt","year":"2025","journal-title":"J Am Coll Cardiol"},{"key":"2026022323463758300_cvaf235-B2","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1002\/ejhf.792","article-title":"Effect of eplerenone in patients with heart failure and reduced ejection fraction: potential effect modification by abdominal obesity. Insight from the EMPHASIS-HF trial","volume":"19","author":"Olivier","year":"2017","journal-title":"Eur J Heart Fail"},{"key":"2026022323463758300_cvaf235-B3","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.3665","article-title":"Mineralocorticoid receptor antagonists in heart failure with reduced ejection fraction according to body weight","author":"Butt","year":"2025","journal-title":"Eur J Heart Fail"},{"key":"2026022323463758300_cvaf235-B4","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1111\/jch.14898","article-title":"Obesity, aldosterone excess, and mineralocorticoid receptor activation: parallel or intersected circumstances?","volume":"26","author":"Puzantian","year":"2024","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"2026022323463758300_cvaf235-B5","doi-asserted-by":"crossref","first-page":"2134","DOI":"10.1161\/CIRCULATIONAHA.115.018226","article-title":"Adipocyte-derived hormone leptin is a direct regulator of aldosterone secretion, which promotes endothelial dysfunction and cardiac fibrosis","volume":"132","author":"Huby","year":"2015","journal-title":"Circulation"},{"key":"2026022323463758300_cvaf235-B6","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/BF00561373","article-title":"Atrial natriuretic factor inhibits ACTH stimulated aldosterone, but not cortisol, secretion in man","volume":"35","author":"McMurray","year":"1988","journal-title":"Eur J Clin Pharmacol"},{"key":"2026022323463758300_cvaf235-B7","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.trsl.2017.06.001","article-title":"Modulation of natriuretic peptide receptors in human adipose tissue: molecular mechanisms behind the \u201cnatriuretic handicap\u201d in morbidly obese patients","volume":"186","author":"Gentili","year":"2017","journal-title":"Transl Res"},{"key":"2026022323463758300_cvaf235-B8","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.jchf.2021.05.022","article-title":"What is the effect of obesity on the natriuretic peptide pathway?","volume":"9","author":"Herrmann","year":"2021","journal-title":"JACC Heart Fail"},{"key":"2026022323463758300_cvaf235-B9","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1038\/s41586-024-07903-1","article-title":"Agonist antibody to guanylate cyclase receptor NPR1 regulates vascular tone","volume":"633","author":"Dunn","year":"2024","journal-title":"Nature"},{"key":"2026022323463758300_cvaf235-B10","doi-asserted-by":"crossref","first-page":"2252","DOI":"10.1056\/NEJMoa2110956","article-title":"Cardiovascular events with finerenone in kidney disease and type 2 diabetes","volume":"385","author":"Pitt","year":"2021","journal-title":"N Engl J Med"}],"container-title":["Cardiovascular Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cardiovascres\/advance-article-pdf\/doi\/10.1093\/cvr\/cvaf235\/65359413\/cvaf235.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cardiovascres\/article-pdf\/122\/1\/14\/65359413\/cvaf235.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cardiovascres\/article-pdf\/122\/1\/14\/65359413\/cvaf235.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T04:46:57Z","timestamp":1771908417000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cardiovascres\/article\/122\/1\/14\/8325493"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,11,18]]},"published-print":{"date-parts":[[2026,2,24]]}},"URL":"https:\/\/doi.org\/10.1093\/cvr\/cvaf235","relation":{},"ISSN":["0008-6363","1755-3245"],"issn-type":[{"value":"0008-6363","type":"print"},{"value":"1755-3245","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1]]},"published":{"date-parts":[[2025,11,18]]}}}