Table 3.

Differences and new findings of the current study in comparison with previous studies

	Study population	LV function measurements	Assessment of LV geometry	Obesity definition	Sex-specific analysis	FU duration	Primary end point	Outcomes
Park et al (ours)	3564 patients with acute HF	LV-GLS and LV-EF	Yes	BMI (kg/m2)	Yes	Median 33.7 months	All-cause mortality	In women, obesity paradox was confined to older patients and those with higher LV-GLS, while in men, obesity paradox was consistently observed.
Shah et al 4	6142 patients with acute HF	LV-EF only	No	BMI (kg/m2)	No	30 days and 1 year	All-cause mortality	Obesity paradox was not present in patients with HFpEF.
Vest et al 5	3811 patients with HFrEF	LV-EF only	No	BMI (kg/m2)	Yes	Median 6.2 years	All-cause mortality	Overweight and obese men had higher mortality, while overweight women showed survival benefit.
Padwal et al 6	23967 patients with chronic HF	LV-EF only	No	BMI (kg/m2)	No	Up to 3 years	All-cause mortality	The obesity paradox was present in both those with reduced and preserved LV systolic function.
Tsujimoto et al 25	3310 patients with HFpEF	None	No	WC (cm)	No	Mean 3.4 years	All-cause mortality	The risk of all-cause mortality was significantly higher in patients with HFpEF with abdominal obesity.

Key differences and new findings are highlighted in bold.

BMI, body mass index; EF, ejection fraction; FU, follow-up; GLS, global longitudinal strain; HF, heart failure; HFpEF, heart failure with preserved ejection fraction; HFrEF, heart failure with reduced ejection fraction; LV, left ventricular; WC, waist circumference.