Season 3 - Ep.24: Visceral adiposity: paradigm shift in HFpEF management - Artificial Intelligence in echocardiography

17 snips

Oct 9, 2025

Join cardiologist Milton Packer as he dives into the critical role of visceral adiposity in managing heart failure with preserved ejection fraction (HFpEF). He explores how SGLT2 inhibitors and GLP-1 agonists shift adipose biology towards a protective state, challenging traditional views. The integration of artificial intelligence in echocardiography systems is also discussed, highlighting its potential for early disease detection and the importance of training on diverse populations to avoid bias. Packer's insights signal a pivotal shift in cardiovascular treatment strategies.

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INSIGHT

MRAs Act On Adipocytes Too

Mineralocorticoid receptors in adipocytes convert fat to a pro-inflammatory state that harms the heart.
Blocking these receptors reverts adipocytes toward a cardioprotective profile.

ADVICE

Combine Therapies For Complementary Effects

Combine SGLT2 inhibitors and MRAs for complementary effects on adipose biology and HFpEF management.
Anticipate future agents that directly suppress specific adipokines to add to this regimen.

INSIGHT

Anti-Obesity Drugs Preferentially Shrink Visceral Fat

GLP-1 receptor agonists (eg, semaglutide, tirzepatide) disproportionately reduce visceral fat versus total weight.
A 10% total weight loss can produce ~25% reduction in visceral adipose tissue and shift adipokines favorably.

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This episode covers:

Cardiology This Week: A concise summary of recent studies
Visceral adiposity: paradigm shift in HFpEF management
Artificial Intelligence in echocardiography
Milestones: ISIS-2

Host: Susanna Price

Guests: Carlos Aguiar, Milton Packer, Rudolf de Boer

Want to watch the episode? Go to: https://esc365.escardio.org/event/2175

Want to watch the extended interview on AI in echocardiography? Go to: https://esc365.escardio.org/event/2175?resource=interview

Disclaimer:

ESC TV Today is supported by Bristol Myers Squibb and Novartis.

This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsors.

This programme is intended for health care professionals only and is to be used for educational purposes.

The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices.

Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.

The ESC is not liable for any translated content of this video. The English language always prevails.

Declarations of interests:

Stephan Achenbach, Yasmina Bououdina, Nicolle Kraenkel and Susanna Price have declared to have no potential conflicts of interest to report.

Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede.

John-Paul Carpenter has declared to have potential conflicts of interest to report: stockholder Mycardium AI.

Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo.

Rudolf de Boer has declared to have potential conflicts of interest to report: the institution of Rudolf de Boer has received research grants and/or fees from Alnylam, AstraZeneca, Abbott, Bristol-Myers Squibb, NovoNordisk, and Roche; Rudolf de Boer has had speaker engagements with and/or received fees from and/or served on an advisory board for Abbott, AstraZeneca, Bristol Myers Squibb, NovoNordisk, Roche, and Zoll; Rudolf de Boer received travel support from Abbott and NovoNordisk.

Konstantinos Koskinas has declared to have potential conflicts of interest to report: honoraria from MSD, Daiichi Sankyo, Sanofi.

Milton Packer has declared to have potential conflicts of interest to report: 89bio, Abbvie, Actavis, Altimmune, Alnylam, Amarin, Amgen, Ardelyx, ARMGO, AstraZeneca, Attralus, Biopeutics, Boehringer Ingelheim, Caladrius, Casana, CSL Behring, Cytokinetics, Daiichi Sankyo, Imara, Lilly, Medtronic, Moderna, Novartis, NovoNordisk, Pharmacocosmos, Regeneron, Roche, Salamandra.

Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada.

Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.