Mobile Applet for Weight Management in Obese Heart Failure Patients

Obesity is one of the major risk factors for heart failure. Current guidelines for heart failure emphasize that severe obesity is associated with a poor prognosis in patients with heart failure, but there are no recommended effective interventions.

Caloric restriction alone, increased exercise, the use of weight-loss drugs, and bariatric surgery are not appropriate for obese patients with heart failure.

Whether obese heart failure patients with reduced ejection fraction (HFrEF) can benefit from weight loss treatment has not been evaluated in randomized controlled trials so far.

This study combines caloric restriction with lifestyle management to help HFrEF patients lose weight.

Inclusion criteria

• Age ≥18 years;
• Left ventricular ejection fraction (LVEF) ≤ 50%, with New York Heart Association (NYHA) class II-III;
• Body mass index (BMI) ≥ 26 kg/m² or male waist-to-hip ratio (WHR=waist circumference/hip circumference) ≥ 0.9, female waist-to-hip ratio ≥ 0.85;
• Ability to use a smartphone and demonstrate compliance via a diet management mobile application during a 2-week ±1-week run-in period;
• History of heart failure hospitalization within the past 6 months;
• Signed informed consent.

Exclusion criteria

• End-stage heart failure (≥2 hospitalizations for heart failure in the past 3 months, intolerance to guideline-directed medical therapy (GDMT), or dependence on inotropic agents);
• Heart failure with reversible causes (e.g., peripartum cardiomyopathy, fulminant myocarditis);
• Moderate or severe anemia (hemoglobin [Hb] <90 g/L);
• Renal insufficiency (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m²) or ongoing dialysis;
• Uncontrolled thyroid disease (hyperthyroidism/hypothyroidism) or end-stage liver failure;
• Alcohol or substance abuse;
• Current use of weight-loss medications or planned bariatric surgery;
• Malignancy with an expected survival <1 year;
• Conditions potentially hindering protocol compliance, as judged by the investigator (e.g., habitual reliance on food delivery services or company cafeteria meals);
• Planned hospitalization during the trial period;
• Concurrent participation in another interventional clinical study.