Heart Failure and Obesity-Related Heart Disease

Prior work in the Framingham Heart Study demonstrated that clinical precursors to HFpEF were distinct from risk factors preceding HFrEF. These initial studies highlight differences in pathophysiology long before the clinical development of HFpEF and HFrEF. This work motivated an international collaborative effort of 4 major community-based cohorts with over 22,000 individuals followed prospectively for incident HF by subtype. The team has developed and validated distinct clinical risk prediction models for HFpEF and HFrEF, and have also demonstrated that adiposity particularly predisposes to HFpEF. These studies support the notion of HFpEF as systemic disease and laid the foundation for the funded NIH R01 focused on upstream inflammatory mediators that may contribute to the pathobiology of HFpEF.

The group and others have demonstrated that vascular dysfunction including increased arterial stiffness and endothelial dysfunction contributed to the pathobiology of HFpEF. An active collaboration with Naomi Hamburg, MD, at Boston University is studying endothelial effects of COVID-19 in obesity. The team hopes to elucidate mechanisms underlying heightened cardiovascular risk after COVID-19 infection.

Through collaborations at the Broad Institute, the group has leveraged diverse machine learning approaches applied to electronic health record and cardiac imaging datasets. They have shown that natural language processing models are able to improve accuracy of HF classification when compared with billing codes. An active collaboration with Patrick Ellinor, MD, at Massachusetts General Hospital is investigating deep learning models on electrocardiograms and echocardiograms to better understand future HF risk.

• Emily Lau, MD, MPH
• Jenna McNeill, MD
• J. Sawalla Guseh, MD

• Mythri Ambatipudi, BS
• Mandana Chitsazan, MD
• Leah Kosyakovsky, MD
• XiaoDan (Vivian) Huo, BA
• Janet Ma, MD
• Ndidi Owunna, BS
• Abigail Pan, BS
• Juhi Parekh, MBBS, MPH
• Mirav Parekh, BS, MA
• Athar Roshandelpoor, PhD
• Dongyu (Daniel) Wang, MD, MPH

• Nona Jiang, MD, MSc
• Mariana Ramirez, MD, MSc
• Christy Taylor, MD, MPH