{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T11:41:41Z","timestamp":1765280501223,"version":"3.44.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Body mass index (BMI) variability is a risk factor for various adverse cardiovascular outcomes. However, the specific associations between BMI variability and the risk of developing heart failure with preserved ejection fraction (HFpEF) versus heart failure with reduced ejection fraction (HFrEF), particularly across multiple weight change trends, remain unexplored.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">This retrospective cohort study analyzed electronic health records from a sample of patients with overweight or obesity. BMI variability was assessed over a 5\u2010year period using average successive variability, with patients categorized into 3 groups: weight loss, stable weight, and weight gain. We subsequently followed 50\u2009812 eligible patients to monitor the incidence of HFpEF and HFrEF. Cox regression models were applied to examine the differential association between BMI variability and HFpEF and HFrEF risk.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Over a median follow\u2010up of 4.52\u2009years, 2128 patients developed HFpEF and 1121 developed HFrEF. After adjusting for relevant confounders, elevated BMI variability was associated with an increased risk of HFpEF. The hazard ratios (HRs) of HFpEF for each 1\u2010SD increment in average successive variability of BMI were 1.37 (95% CI, 1.17\u20131.59) in the weight loss group and 1.24 (95% CI, 1.11\u20131.40) in the stable weight group. Additionally, when analyzed as a binary variable divided by the median, BMI variability above the median was associated with higher risks of HFpEF compared with those below the median, with the corresponding HRs being 1.47 (95% CI, 1.21\u20131.79) for the weight loss group and 1.20 (95% CI, 1.06\u20131.35) for the stable weight group. Among patients who experienced weight gain, BMI variability was not significantly associated with the risk of incident HFpEF or HFrEF (HR, 1.16 [95% CI, 0.88\u20131.53]; modeled as a continuous variable).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this large cohort of individuals living with overweight or obesity, greater variability in BMI was significantly associated with a higher risk of developing HFpEF among those with reduced or stable weight.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.039976","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T11:50:21Z","timestamp":1757591421000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association of Long\u2010Term Body Mass Index Variability With the Development of Heart Failure With Preserved Ejection Fraction and Heart Failure With Reduced Ejection Fraction Across Patterns of Weight Change"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4535-8770","authenticated-orcid":false,"given":"Zeshui","family":"Yu","sequence":"first","affiliation":[{"name":"University of Pittsburgh, School of Pharmacy","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5167-1080","authenticated-orcid":false,"given":"Yuqing","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, University of Pittsburgh","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oshin","family":"Miranda","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, School of Pharmacy","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0180-3588","authenticated-orcid":false,"given":"Meiyuzhen","family":"Qi","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, University of Pittsburgh","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2689-1465","authenticated-orcid":false,"given":"Manling","family":"Zhang","sequence":"additional","affiliation":[{"name":"Vascular Medicine Institute, University of Pittsburgh School of Medicine","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3639-3128","authenticated-orcid":false,"given":"Ning","family":"Feng","sequence":"additional","affiliation":[{"name":"Vascular Medicine Institute, University of Pittsburgh School of Medicine","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy P.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Lilly Corporate Center","place":["Indianapolis, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3737-4316","authenticated-orcid":false,"given":"Nanette Cathrin","family":"Schloot","sequence":"additional","affiliation":[{"name":"Lilly Deutschland GmbH","place":["Bad Homburg, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5331-0463","authenticated-orcid":false,"given":"Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Lilly Corporate Center","place":["Indianapolis, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8442-9362","authenticated-orcid":false,"given":"Flora","family":"Sam","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company, Lilly Corporate Center","place":["Indianapolis, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1797-9967","authenticated-orcid":false,"given":"Lirong","family":"Wang","sequence":"additional","affiliation":[{"name":"University of Pittsburgh, School of Pharmacy","place":["Pittsburgh, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01448-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvac120"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.112.972828"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-020-01349-3"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq426"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001052"},{"key":"e_1_3_2_8_2","unstructured":"America HFSo . 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