Key result
Proactive multimodal HF screening achieves ~92% acceptability in adults with obesity.
Why the study?
Obesity is strongly associated with heart failure but recognition in primary care is challenging due to difficult interpretation of symptoms, physical findings, and natriuretic peptide concentrations.
Does proactive multimodal heart failure screening reduce the 1-year risk of left ventricular dysfunction and/or acute heart failure hospitalization compared with usual care in adults aged ≥45 years with obesity and no known cardiac disease?
RCT (n=420)
Open-label (with blinded central echocardiographic assessment and independent blinded adjudication of acute HF hospitalizations)
1:1 randomization using variable permuted blocks of four, six, and eight, stratified by participating CLI programme or dietetic practice
Yes
Does proactive multimodal heart failure screening reduce the 1-year risk of left ventricular dysfunction and/or acute heart failure hospitalization compared with usual care in adults aged ≥45 years with obesity and no known cardiac disease?
This baseline report of the SCORHFE randomized trial demonstrates that recruiting adults with obesity through primary care lifestyle pathways successfully reaches a high-risk cohort with near-universal central obesity and high acceptability for proactive multimodal heart failure screening.
BACKGROUND: Obesity is strongly associated with heart failure, but recognition remains challenging in primary care because symptoms, physical findings, and natriuretic peptide concentrations may be difficult to interpret. OBJECTIVES: To describe the design, recruitment, baseline characteristics, and acceptability of a trial evaluating proactive multimodal heart failure screening in adults with obesity. METHODS: Adults aged 45 years or older with obesity and no known cardiac disease were randomised 1:1 to proactive multimodal heart failure screening or usual care. Screening comprised medical history, physical examination, blood sampling, 12-lead electrocardiography, and transthoracic echocardiography. The primary endpoint is left ventricular dysfunction and/or acute heart failure hospitalisation at 1 year. RESULTS: Between March 2024 and June 2025, 746 individuals expressed interest, 629 (84.3%) underwent eligibility assessment, and 420 were randomised. Mean age was 58.3 ± 8.4 years, 295 participants (70.2%) were women, and median body mass index was 35.0 [32.4-38.0] kg/m2. Among 385 participants with available waist circumference data, 379 (98.4%) had central obesity. Ninety-seven participants (23.1%) had two or more cardiometabolic conditions. Among a random subset of 50 screened participants, 46 (92.0%) considered screening duration acceptable, 47 (94.0%) reported low procedural burden, and 46 (92.0%) supported routine implementation. CONCLUSIONS: Recruitment through primary care obesity pathways reached adults with substantial adiposity and cardiometabolic burden. Screening acceptability was high in a random subset. One-year follow-up will determine clinical and economic effects.
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Motiram et al. (2026) conducted an RCT in Obesity without known cardiac disease (n=420). Proactive multimodal heart failure screening vs. Usual care was evaluated on Composite of left ventricular dysfunction (LVEF <50%, average E/e' ≥15, or LV global longitudinal strain less negative than -16%) and/or acute heart failure hospitalization at 1 year. Proactive multimodal heart failure screening randomized 420 adults with obesity (mean age 58.3 years, 70.2% women) with 92.0% acceptability; 1-year primary outcome follow-up is ongoing.
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