Understanding weight loss in patients with heart failure.

Doctor Emilia Nan Tie, Baker Heart and Diabetes Institute

Postgraduate Scholarship

Years funded: 2026 - 2028

Heart diseases are responsible for a third of all deaths globally. Heart failure with preserved ejection fraction (HFpEF) stands as the most prevalent form of heart disease, disproportionately impacting those battling obesity, and impacting twice as many women as men. Although the heart maintains its pumping capacity, in HFpEF, alterations in heart pressures and muscle scarring impair function. There few therapies that reduce mortality in HFpEF. My study endeavours to unveil whether these detrimental changes can be reversed through weight loss and to explore whether different methods—like medication or surgery—yield distinct effects.

I will compare two innovative weight loss strategies in individuals facing obesity with HFpEF: the groundbreaking injectable medication tirzepatide and bariatric surgery, to a traditional diet and exercise plan. I will employ cutting-edge heart imaging techniques—including MRI and metabolic imaging—alongside exercise assessments, blood analysis, and invasive heart pressure monitoring, to comprehensively evaluate the impact of each treatment after one year. I anticipate that significant weight loss will lead to improved heart function, reduced scarring, and alleviated symptoms. The results could pave the way for larger studies aimed at improving outcomes for men and women, particularly by improving quality of life and curtailing hospital admissions, medication reliance, and healthcare costs.

Diagnosing HFpEF is a complex challenge, especially within obese populations. My research will also probe whether early indicators of cardiac damage, identifiable through heart MRI—such as muscle scarring or fat deposition—can serve as non-invasive markers for HFpEF. These markers could play a pivotal role in recognising individuals at heightened risk of sudden cardiac death, a significant concern among the obese demographic. Over the course of three years, we will track patients to determine if greater levels of scarring or fat accumulation correlate with the onset of HFpEF, hospitalization rates, or incidence of sudden cardiac events. This may establish heart MRI as a safer, more accessible diagnostic alternative for HFpEF in those with obesity.

The outcomes of this research will be disseminated through scientific journals, conferences, and clinical networks. Additionally, the plan is to create a comprehensive registry dedicated to monitoring heart health in individuals with obesity, identifying those at elevated risk and informing future preventive and therapeutic strategies.

Ultimately, I aspire to elevate the quality of life and health outcomes for individuals grappling with obesity and HFpEF, alleviating the burden of this condition on both patients and the healthcare system.