Both obesity and type 2 diabetes mellitus are important risk factors for the development of heart failure with preserved ejection fraction (HFpEF), and both disorders increase the risk of systemic thromboembolic events. Traditionally, the risk of stroke has been explained by the strong association of these disorders with atrial fibrillation (AF).

Editors

Editor-in-Chief
Christopher O’Connor, MD, FACC

Executive Editor
Mona Fiuzat, PharmD, FACC

JACC Heart Failure CME Editors
Tariq Ahmad, MD, MPH
Adam DeVore, MD
Abhinav Sharma, MD
Mitchell Psotka, MD, PhD
Kishan Parikh, MD

Author
Milton Packer, MD

Target Audience

JACC Journal CME/MOC/ECME is intended for physicians who treat patients with cardiovascular disease.

Important Dates

Date of Release: December 30, 2019
Term of Approval/Date of CME/MOC/ECME Expiration: December 29, 2020

Learner Objectives

After reading this article the reader should be able to:

• Explain the pathogenesis of atrial fibrillation and heart failure with preserved ejection fraction in patients with obesity or type 2 diabetes mellitus.
• Discuss the evidence that has questioned a causal relationship between atrial fibrillation and stroke.
• Describe the role of atrial myopathy in the pathogenesis of stroke in patients with obesity and type 2 diabetes mellitus.
• Outline the mechanisms by which heart failure with preserved ejection fraction increases the likelihood of clinical and subclinical cerebral infarction.
• Discuss the limitations of rhythm-control strategies in preventing stroke in patients with obesity and type 2 diabetes who have atrial fibrillation.

Method of Participation and Claiming Credit
This ACC JACC Journals CME/MOC/ECME activity includes the reading of an article published in one of the JACC journals and the successful completion of self-assessment questions.  

Requesting AMA PRA Category 1 CME Credit™ and/or MOC or ECME credit for this Activity
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1. Read the article for which you wish to receive credit.
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