AHA Scientific Sessions 2025 - Dr Milton Packer (Baylor University Medical Center, US) joins us to discuss his novel unifying hypothesis that heart failure with preserved ejection fraction arises primarily from visceral adipose tissue dysfunction and altered adipokine signaling, rather than as a heterogeneous disorder driven by multiple comorbidities.

Interview Questions:

1. Can you explain the core premise of the adipokine hypothesis?
2. Could you walk us through the three domains of adipokine signaling and how the imbalance between these domains leads to the development of HFpEF?
3. What are the key lines of evidence that support the link between visceral adiposity and HFpEF, particularly the temporal relationship between adipose dysfunction and disease development?
4. How do the molecular, pathophysiological, and clinical features of obesity parallel those seen in HFpEF, and what does this tell us about disease mechanisms?
5. What are the implications of this framework for how we approach treatment of HFpEF, both with current therapies and in terms of developing novel targeted interventions?
6. How confident are we that the Adipokine Hypothesis explains HFpEF in most people with the disease?

Visit our AHA 2025 Late-Breaking and Featured Science Collection page for more coverage.

Recorded on-site at AHA Scientific Sessions 2024, Chicago.
Editors: Greg Guillory.
Videographer: Mike Knight, David Ben-Harosh, Dan Brent.
Support: This is an independent interview produced by Radcliffe Cardiology.