Season 3 - Ep.24: Visceral adiposity: paradigm shift in HFpEF management - Artificial Intelligence in echocardiography

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Oct 9, 2025

Join cardiologist Milton Packer as he dives into the critical role of visceral adiposity in managing heart failure with preserved ejection fraction (HFpEF). He explores how SGLT2 inhibitors and GLP-1 agonists shift adipose biology towards a protective state, challenging traditional views. The integration of artificial intelligence in echocardiography systems is also discussed, highlighting its potential for early disease detection and the importance of training on diverse populations to avoid bias. Packer's insights signal a pivotal shift in cardiovascular treatment strategies.

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INSIGHT

Visceral Fat Drives HFpEF

Visceral adiposity is the key abnormality driving HFpEF, more than individual comorbidities like diabetes or hypertension.
Adipose tissue secretes pro-inflammatory adipokines that cause hypertrophy, fibrosis and microvascular dysfunction in the heart.

INSIGHT

Adipokine Hypothesis Supported By Experiments

Experimental suppression of adipokines in adipose tissue prevents development of HFpEF in models.
This supports the adipokine hypothesis linking dysfunctional fat to cardiac disease.

ADVICE

Use SGLT2 Inhibitors To Target Adipose Biology

Use SGLT2 inhibitors to modify adipocyte biology and reduce harmful adipokines, not just for glycosuria.
Expect visceral adiposity to shrink and cardioprotective adipokines to rise with SGLT2 therapy.

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This episode covers:

Cardiology This Week: A concise summary of recent studies
Visceral adiposity: paradigm shift in HFpEF management
Artificial Intelligence in echocardiography
Milestones: ISIS-2

Host: Susanna Price

Guests: Carlos Aguiar, Milton Packer, Rudolf de Boer

Want to watch the episode? Go to: https://esc365.escardio.org/event/2175

Want to watch the extended interview on AI in echocardiography? Go to: https://esc365.escardio.org/event/2175?resource=interview

Disclaimer:

ESC TV Today is supported by Bristol Myers Squibb and Novartis.

This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

The ESC is not liable for any translated content of this video. The English language always prevails.

Declarations of interests:

Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

Rudolf de Boer has declared to have potential conflicts of interest to report: the institution of Rudolf de Boer has received research grants and/or fees from Alnylam, AstraZeneca, Abbott, Bristol-Myers Squibb, NovoNordisk, and Roche; Rudolf de Boer has had speaker engagements with and/or received fees from and/or served on an advisory board for Abbott, AstraZeneca, Bristol Myers Squibb, NovoNordisk, Roche, and Zoll; Rudolf de Boer received travel support from Abbott and NovoNordisk.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Milton Packer has declared to have potential conflicts of interest to report: 89bio, Abbvie, Actavis, Altimmune, Alnylam, Amarin, Amgen, Ardelyx, ARMGO, AstraZeneca, Attralus, Biopeutics, Boehringer Ingelheim, Caladrius, Casana, CSL Behring, Cytokinetics, Daiichi Sankyo, Imara, Lilly, Medtronic, Moderna, Novartis, NovoNordisk, Pharmacocosmos, Regeneron, Roche, Salamandra.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.