Beyond Adiposity: Embracing Complexity in Diabetes-Associated HFpEF
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HM Krumholz, SE Inzucchi
Journal of the American College of Cardiology, 2025
jacc.org
The search for a unifying mechanism leading to heart failure (HF) with preserved ejection fraction (HFpEF) is both necessary and perilous—necessary because complexity can paralyze scientific progress, and perilous because oversimplification can mislead it. In this issue of JACC, Packer et al 1 advance a bold and thought-provoking thesis: that visceral adiposity, not hyperglycemia, is the dominant modifiable driver linking type 2 diabetes to HFpEF. Their hypothesis reframes a longstanding debate and proposes a conceptual …
