Metabolic phenotypes and cardiac function: Insights from UK Biobank cardiac MRI and outcomes analysis

Motivation: Cardiac dysfunction patterns preceding cardiovascular events in different metabolic phenotypes remain poorly understood, limiting effective risk stratification in the general population despite rising obesity and metabolic disease rates. Goal(s): To characterize cardiac adaptation patterns across metabolic phenotypes using UK Biobank cardiac MRI data and determine their association with long-term cardiovascular outcomes. Approach: Analysis of cardiac structure, function, and clinical outcomes in 28,897 participants stratified by metabolic health and obesity status. Results: Metabolic phenotypes showed distinct cardiac adaptations despite preserved ejection fraction, with both obesity and metabolic health status independently contributing to cardiovascular event risk. Impact: This large-scale analysis reveals unique cardiac phenotypes across metabolic categories, providing new insights for early cardiovascular risk assessment in metabolically diverse populations.