Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Cardiol. Oct 26, 2026; 18(10): 125519
Published online Oct 26, 2026. doi: 10.4330/wjc.125519
Published online Oct 26, 2026. doi: 10.4330/wjc.125519
Maladaptive lipid partitioning in obesity-related heart failure with preserved ejection fraction: From depot dysfunction to metabolic phenotyping
Si-Shang Qin, Zi-Min Wu, Bao-Shi Zheng, Cheng Luo, Department of Cardiovascular Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Co-first authors: Si-Shang Qin and Zi-Min Wu.
Co-corresponding authors: Bao-Shi Zheng and Cheng Luo.
Author contributions: Qin SS contributed to the review conceptualization and the manuscript drafting; Qin SS, Wu ZM, and Luo C contributed to the review and the revision of the manuscript; Luo C and Zheng BS contributed to the supervision of the work; Zheng BS contributed to the project administration and funding acquisition. Zheng BS and Luo C contributed equally to this work as co-corresponding authors. Qin SS and Wu ZM contributed equally to this work as co-first authors.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Supported by the Natural Science Foundation of Guangxi, No. 2025GXNSFAA069056; the National Natural Science Foundation of China, No. 82360066; and the Guangxi Key Research and Development Program Project, No. guikeAB24010153.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Cheng Luo, MD, Postdoc, Assistant Professor, Department of Cardio
Received: July 9, 2026
Revised: September 9, 2026
Accepted: October 13, 2026
Published online: October 26, 2026
Processing time: 106 Days and 12.9 Hours
Revised: September 9, 2026
Accepted: October 13, 2026
Published online: October 26, 2026
Processing time: 106 Days and 12.9 Hours
Core Tip
Core Tip: Obesity-related heart failure with preserved ejection fraction cannot be adequately characterized by body mass alone. This minireview focuses on the less frequently explored consequences of failed lipid storage: Depot-specific lipid rerouting across visceral, hepatic, skeletal muscle, epicardial/perivascular, and myocardial compartments, together with impaired myocardial substrate flexibility. We distinguish human associations from mechanistic evidence and propose adiposity-aware phenotyping as a research framework rather than a validated treatment algorithm. Recent cardiometabolic trials illustrate how complementary components of this phenotype may be therapeutically modifiable.