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similarly, in the pulmonary circulation, endothelial dysfunction has been identified as an early event leading to the development of pulmonary hypertension in the context of experimental heart failure [21]

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However, we know that BMI is just one piece of the puzzle

The amelioration of symptoms as assessed by the Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score, and improvements in exercise function seemed to be directly related to the magnitude of weight loss, such that greater improvement was observed with greater body weight loss (Borlaug et al

This leaves you lighter but not leaner, a condition sometimes called being skinny fat