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Heart failure with preserved ejection fraction (HFpEF) is a form of heart failure in which the ejection fraction – the percentage of the volume of blood ejected from the left ventricle with each heartbeat divided by the volume of blood when the left ventricle is maximally filled – is normal, defined as greater than 50%; [1] this may be measured by echocardiography or cardiac catheterization.
The paradox was first described in 1999 in overweight and obese people undergoing hemodialysis [89] and has subsequently been found in those with heart failure and peripheral artery disease (PAD). [90] In people with heart failure, those with a BMI between 30.0 and 34.9 had lower mortality than those with a normal weight.
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