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As compared with nonobese HFpEF, patients with obesity-related HFpEF display distinct pathophysiologic features, including greater volume expansion 5,17 , more severe inflammation 6,7 , increases in visceral and paracardiac adipose tissue 5,15,18,19 and more severe myocardial injury 15

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This is especially important for patients with diabetes, kidney disease, gastrointestinal symptoms or medications that may interact with glucose control