Evidence map›Paper›PMID 41635389›Full record

ReviewCureus2026

The Metabolic Heart: Reframing Heart Failure With Preserved Ejection Fraction as a Systemic Cardio-Metabolic Syndrome.

Debasrita Baidya, Abhishek Hanumanpratap Singh Kshatri, Emi K Zerzan, Gayathri J Menon, Mihika Sawale, Sunny Subhash Bhalodiya

Abstract readReview
In one paragraph

Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Debasrita BaidyaBiomedical Sciences, Indian Institute of Technology Patna, Bihta, IND.
Abhishek Hanumanpratap Singh KshatriEmergency Medicine, Apollo Hospitals Health City, Visakhapatnam, IND.
Emi K ZerzanCollege of Natural Science, The University of Texas at Austin, Texas, USA.
Gayathri J MenonCardiology, Dr. Chandramma Dayanand Sagar Institute of Medical Education and Research (CDSIMER), Bengaluru South District, IND.
Mihika SawaleInternal Medicine, K.J. Somaiya Medical College and Research Centre, Mumbai, IND.
Sunny Subhash BhalodiyaInternal Medicine, Hinduhrudaysamrat Balasaheb Thackarey Medical College, Mumbai, IND.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This review critically reassesses heart failure with preserved ejection fraction (HFpEF) as a systemic cardio-metabolic disorder. Searching PubMed, Scopus, and Web of Science (2000-2025) yielded 108 priority studies, randomized controlled trials (RCTs), prospective cohorts, and mechanistic reports after screening ~800 records. Evidence shows visceral adiposity, insulin resistance, chronic inflammation and mitochondrial dysfunction synergistically impair cardiac energetics. Unlike conventional neuro-hormonal blockade (renin angiotensin aldosterone system or RAAS inhibitors, beta-blockers), which showed neutral outcomes in heterogeneous HFpEF populations, landmark RCTs (EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction (EMPEROR-Preserved), Dapagliflozin Evaluation to Improve the Lives of Patients With Preserved Ejection Fraction Heart Failure (DELIVER)) now demonstrate that sodium-glucose cotransporter-2 inhibitors cut hospitalizations and cardiovascular events, while glucagon-like peptide-1 (GLP-1) receptor agonists improve symptoms, exercise tolerance and weight, validating the metabolic-inflammation paradigm. Persistent phenotypic heterogeneity underscores the need for biomarker-driven phenotyping, advanced imaging and adaptive trial designs to embed metabolic and bioenergetic dimensions into early, precision care.

Indexed as

cardio-metabolic syndromeepicardial adipose tissueglp-1 receptor agonistsheart failure with preserved ejection fractioninsulin resistancemetabolic heart diseasemitochondrial dysfunctionprecision medicinesglt2 inhibitorssystemic inflammation

Identifiers

PMID41635389
PMCPMC12862494

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.