Initial Complaints: A 54-year-old male, presented with fatigue, mild shortness of breath, and occasional ankle swelling.

Brief History: His medical history includes well-controlled type 2 diabetes mellitus (T2D), hypertension, and obesity (BMI 32 kg/m²). He has no prior history of coronary artery disease or myocardial infarction, but both parents had heart disease.

Clinical Examination: Physical examination revealed bilateral ankle edema, jugular venous distension, and slightly elevated blood pressure (140/90 mmHg).

His weight was 110 kg, and heart sounds were regular with no murmurs. Symptoms included shortness of breath on exertion, likely exacerbated by obesity.

Diagnostic Workup: Echocardiography showed preserved left ventricular ejection fraction (LVEF) of 68%, indicating normal pump function. However, global longitudinal strain (GLS) was -16%, suggesting subclinical left ventricular dysfunction likely due to long-standing hypertension, diabetes, and obesity.

Laboratory Results: Routine blood tests indicated HbA1c at 6.8%. Kidney function was normal (eGFR 72 mL/min/1.73 m²). N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were slightly elevated, indicating cardiac stress. The lipid panel revealed elevated triglycerides and borderline high LDL cholesterol.

1. What is the patient’s diagnosis based on the presented symptoms and diagnostic findings?
2. What percentage of patients with heart failure also have obesity-related complications?
3. What are the next steps in management for this patient?

At the American Heart Association’s centennial conference, Dr. Amit Khera, Director of Preventive Cardiology and Professor at UT Southwestern Medical Center, and Dr. John L. Sapp, Assistant Dean of Clinical Research at Dalhousie University, presented key findings. Topics included Tirzepatide’s impact on HFpEF and obesity, the comparison of left atrial appendage closure versus anticoagulation for atrial fibrillation, intensive blood pressure control in diabetes, and insights from the VANISH2 trial on ventricular tachycardia. These findings provide healthcare professionals with evidence-based strategies to advance cardiovascular care.