Weight loss improves heart muscle contraction in people with severe obesity and a common form of heart failure, according to a Johns Hopkins Medicine study funded by the National Institutes of Health.
How weight loss affects heart muscle cells in HFpEF
Researchers analyzed heart muscle cells from patients with heart failure with preserved ejection fraction (HFpEF) and found weakened force production in cells from individuals with a body mass index over 40 kg/m². In a subgroup that underwent weight loss therapy, those who lost the most weight showed improved contraction of their heart muscle cells, suggesting the dysfunction may be reversible.
What the study identified as a potential drug target
The team identified a chemical change in the protein troponin I that weakens heart muscle contraction, which was more pronounced in patients with HFpEF and severe obesity. This positions troponin I as a possible target for future medications aimed at treating this specific patient group.
Why this matters for a growing patient population
HFpEF affects nearly half of the 6.6 million people in the United States with heart failure and carries a one-year mortality rate of 20 to 29 percent, according to the American College of Cardiology. The condition disproportionately impacts people with severe obesity, marking a shift from its historical association with aging, hypertension, and fibrosis.
What is HFpEF and how is it different from other heart failure types?
In HFpEF, the heart’s main pumping chamber contracts normally but is stiff and slow to relax, making it difficult to fill with blood. This differs from heart failure with reduced ejection fraction, where the heart muscle is weakened and cannot contract effectively.
Can weight loss reverse heart damage in HFpEF patients?
The study found that patients who lost the most weight had improved heart muscle cell contraction, indicating that at least some of the contractile dysfunction associated with HFpEF and severe obesity may be reversible through weight loss.
