Proactive cardiac screening in adults with obesity identified suspected heart failure in 56.7% of screened individuals, alongside a substantial burden of undiagnosed cardiometabolic conditions.
RCT (n=420)
1:1
Does proactive cardiac screening improve the identification of heart failure and cardiometabolic risk factors in adults with obesity without known cardiac history compared to usual care?
Proactive cardiac screening in adults with obesity without known cardiac history reveals a high prevalence of suspected heart failure and undiagnosed cardiometabolic risk factors.
Abstract Obesity significantly increases the risk of heart failure (HF), but diagnosis is frequently missed or delayed since symptoms and routine biomarkers lack specificity in individuals with obesity. This results in poorer outcomes and increased healthcare costs. The SCreening adults with Obesity to Reduce Heart Failure Events (SCORHFE) study is designed to assess the diagnostic yield of active screening for HF and its risk factors in primary care settings among adults with obesity. Here we present the baseline characteristics of the study population and the findings of the screening. The SCreening adults with Obesity to Reduce Heart Failure Events (SCORHFE) study is a pragmatic randomized trial conducted in the Netherlands. Adults ≥45 years with a body mass index ≥30 kg/m² without known cardiac history were randomized 1:1 to cardiac screening focused on HF versus usual care (n=420; 210 per arm). Screening included standardized medical history and physical examination, laboratory testing including NT-proBNP, a 12-lead ECG, and transthoracic echocardiography. HF diagnosis was assessed in accordance with international guidelines. Randomisation resulted in well-balanced arms: average age ~58 years, ~70% female and mean BMI ~35 kg/m². In the screening arm, 55.3% of the individuals reported exertional dyspnoea and 44.7% experienced ankle oedema. 56.7% met the criteria for suspected HF based on symptoms plus structural or functional echocardiographic abnormalities and/or increased NT-proBNP. Screening also identified a substantial burden of undiagnosed or inadequately managed other cardiometabolic conditions: e.g. new hypertension in 22.1% (known but poorly regulated in 27.9%), new type 2 diabetes in 2.4% (known but poorly regulated in 6.8%), and new dyslipidemia in 46.7% (known but poorly regulated in 26.7%). For 209 individuals this resulted in targeted referral and subsequently treatment by their own general practitioner or specialist when indicated according to the prevailing guidelines. Proactive cardiac screening in individuals with obesity demonstrated high prevalence of suspected HF and a significant burden of treatable cardiometabolic risk factors. These results highlight the potential for systematic screening as a promising strategy for earlier identification of HF in obesity, leading towards timely intervention, improved outcomes, and lower healthcare costs.Study Flow DiagramFor image description, please refer to the figure legend and surrounding text.
Motiram et al. (Mon,) conducted a rct in Obesity (n=420). Proactive cardiac screening focused on heart failure vs. Usual care was evaluated on Diagnostic yield of active screening for HF (suspected HF based on symptoms plus structural or functional echocardiographic abnormalities and/or increased NT-proBNP). Proactive cardiac screening in adults with obesity identified suspected heart failure in 56.7% of screened individuals, alongside a substantial burden of undiagnosed cardiometabolic conditions.