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Akinori Sairaku Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Yukiko Nakano Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Yuko Uchimura Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Takehito Tokuyama Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Hiroshi Kawazoe Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Yoshikazu Watanabe Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Hiroya Matsumura Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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Yasuki Kihara Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan

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-scale cohort studies have shown that subclinical hypothyroidism with a TSH level of ≥10 mIU/L was associated with an increased risk of heart failure ( 7 , 8 ). As major symptoms of heart failure are attributed to an increased left atrial (LA) pressure ( 9

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Xiaoyi Qi Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
Medical College, Shantou University, Shantou, China

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Liangxian Qiu Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Shijia Wang Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Xiongbiao Chen Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Qianwen Huang Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Yixuan Zhao Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China
Medical College, Shantou University, Shantou, China

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Kunfu Ouyang Department of Cardiovascular Surgery, Peking University Shenzhen Hospital, School of Chemical Biology and Biotechnology, State Key Laboratory of Chemical Oncogenomics, Peking University Shenzhen Graduate School, Shenzhen, China

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Yanjun Chen Departments of Cardiology, Peking University Shenzhen Hospital, Shenzhen, China

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Introduction Heart failure (HF) is a complex, multifactorial clinical syndrome characterized by dyspnea and fluid retention caused by impaired systolic or diastolic cardiac function ( 1 , 2 ). In 2017, there were 64.3 million cases of HF

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Federica Saponaro Department of Surgical, Medical, Molecular and Critical Area Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy
Endocrinology Unit 2, University of Pisa, Pisa, Italy

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Alessandro Saba Department of Surgical, Medical, Molecular and Critical Area Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy
Laboratory of Clinical Pathology, University Hospital of Pisa, Pisa, Italy

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Sabina Frascarelli Department of Surgical, Medical, Molecular and Critical Area Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy

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Concetta Prontera Fondazione Toscana Gabriele Monasterio, Pisa, Italy

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Aldo Clerico Fondazione Toscana Gabriele Monasterio, Pisa, Italy

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Marco Scalese Institute of Clinical Physiology, National Council of Research, Pisa, Italy

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Maria Rita Sessa Laboratory of Endocrinology, University Hospital of Pisa, Pisa, Italy

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Filomena Cetani Endocrinology Unit 2, University of Pisa, Pisa, Italy

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Simona Borsari Endocrinology Unit 2, University of Pisa, Pisa, Italy

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Elena Pardi Endocrinology Unit 2, University of Pisa, Pisa, Italy

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Antonella Marvelli Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy

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Claudio Marcocci Endocrinology Unit 2, University of Pisa, Pisa, Italy

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Claudio Passino Fondazione Toscana Gabriele Monasterio, Pisa, Italy

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Riccardo Zucchi Department of Surgical, Medical, Molecular and Critical Area Pathology, Laboratory of Biochemistry, University of Pisa, Pisa, Italy

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Introduction Heart failure (HF) is a complex and chronic condition and despite advances in therapeutic options, its prognosis remains poor, with high mortality and morbidity. Vitamin D (VitD) has been recently emerged as a factor for HF risk

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Jens P Goetze
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Linda M Hilsted
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Jens F Rehfeld
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Urban Alehagen Department of Clinical Biochemistry, Division of Cardiovascular Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

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Introduction Heart failure is a syndrome comprising cardiac dysfunction and neurohumoral activation. Medical treatment aims at neutralizing hormonal actions by blocking receptors or inhibiting activation of vasoconstrictive substances. In particular

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Paweł Komarnicki Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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Paweł Gut Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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Jan Musiałkiewicz Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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Maja Cieślewicz Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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Adam Maciejewski Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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Prachi Patel Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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George Mastorakos Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Marek Ruchała Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Poznań, Poland

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hormone secretion (predominantly serotonin), which leads to the formation of fibrous, plaque-like deposits on the patient’s endocardium and heart valves. Progressive deformation of the valves results in heart failure, usually right-sided ( 19 ). N

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Marie Oertel Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital, University of Würzburg, Würzburg, Germany

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Christian G Ziegler Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital, University of Würzburg, Würzburg, Germany
Department of Internal Medicine III, University Hospital Carl Gustav Carus Dresden, Dresden, Germany

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Michael Kohlhaas Comprehensive Heart Failure Center, Würzburg, Germany

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Alexander Nickel Comprehensive Heart Failure Center, Würzburg, Germany

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Simon Kloock Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital, University of Würzburg, Würzburg, Germany

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Christoph Maack Comprehensive Heart Failure Center, Würzburg, Germany

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Vasco Sequeira Comprehensive Heart Failure Center, Würzburg, Germany

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Martin Fassnacht Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital, University of Würzburg, Würzburg, Germany

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Ulrich Dischinger Division of Endocrinology and Diabetes, Department of Internal Medicine, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, Würzburg, Germany

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.1056/NEJMsr1606602 ) 7 Pandey A LaMonte M Klein L Ayers C Psaty BM Eaton CB Allen NB Lemos de JA Carnethon M Greenland P , et al. Relationship between physical activity, body mass index, and risk of heart failure . Journal of the

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Ann-Cathrin Koschker Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany

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Bodo Warrings Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany

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Caroline Morbach Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Florian Seyfried Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany

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Nicole Rickert Department of Radiology, University Hospital, University of Würzburg, Würzburg, Germany

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Pius Jung Division of Pneumology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Andreas Geier Division of Hepatology, Department of Internal Medicine II, University Hospital, University of Würzburg, Würzburg, Germany

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Ulrich Dischinger Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Maike Krauthausen Department of General Practice, University Hospital, University of Würzburg, Würzburg, Germany

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Martin J Herrmann Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, University of Würzburg, Würzburg, Germany

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Christine Stier Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Department of General, Visceral, Transplant, Vascular, and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany

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Stefan Frantz Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Uwe Malzahn Center for Clinical Trials, University Hospital, University of Würzburg, Würzburg, Germany

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Stefan Störk Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany
Division of Cardiology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany

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Martin Fassnacht Division of Endocrinology and Diabetology, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
Comprehensive Heart Failure Center, University & University Hospital Würzburg, Würzburg, Germany

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the WAS Study Group
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the WAS Study Group

the risk of new-onset heart failure, particularly heart failure with preserved ejection fraction ( 4 , 5 ). Patients with morbid obesity appear to carry a significantly higher mortality risk ( 6 , 7 ). Currently, bariatric surgery is the only

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Madalena von Hafe Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal

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João Sergio Neves Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal

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Catarina Vale Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal

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Marta Borges-Canha Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal

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Adelino Leite-Moreira Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal

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-called fetal gene reprogramming which increases the expression of β-MHC and decreases the expression of α-MHC and SERCA2 ( 11 ). This phenotype presents substantial implications on myocardial function and subsequent progression to heart failure ( 12 ). The

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Hugo R Ramos Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina

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Andreas L Birkenfeld Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina
Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina

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Adolfo J de Bold Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina

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correlate with an increase in plasma cNP in heart failure (5, 6) . However, studies on cardiac transplant patients have shown that plasma cNP levels remain high even after intra-cardiac pressures normalize following transplantation (7) . During an acute

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Richard P Steeds Department of Cardiology, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK

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Vandana Sagar Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK

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Shishir Shetty Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK

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Tessa Oelofse Departments of Anaesthesia and Intensive Care, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Harjot Singh Departments of Anaesthesia and Intensive Care, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Raheel Ahmad Department of Cardiology, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Elizabeth Bradley Therapy Services (Dietetics), University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Rachel Moore Departments of Anaesthesia and Intensive Care, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Suzanne Vickrage Birmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Stacey Smith Birmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Ivan Yim Department of Cardiothoracic Surgery, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Yasir S Elhassan Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK

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Hema Venkataraman Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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John Ayuk Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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Stephen Rooney Department of Cardiothoracic Surgery, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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Tahir Shah Birmingham Neuroendocrine Tumour Centre, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK
Department of Hepatology and Liver Transplantation, University Hospitals Birmingham (Queen Elizabeth), NHS Hospitals Foundation Trust, Birmingham, UK

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features of heart failure. Even when patients are diagnosed early, the onset and progression of CHD is unpredictable. Optimum management of the patient therefore requires close collaboration between multiple experts in order to control carcinoid and

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