WEDNESDAY, May 20, 2026 (HealthDay News) -- For patients with heart failure, the low body mass index (BMI) and high waist-to-hip ratio (WHR) phenotype is associated with an increased risk for all-cause mortality, according to a study presented at the European Society of Cardiology Heart Failure 2026, held from May 9 to 12 in Barcelona, Spain.Camilla van der Hoef, from the University Medical Centre Groningen in the Netherlands, and colleagues examined the clinical phenotypes associated with BMI and WHR and all-cause mortality in patients with heart failure. A total of 1,467 patients were categorized according to BMI and WHR and divided into four phenotypic BMI/WHR quadrants: low BMI/high WHR ("lemon-on-sticks"), high BMI/low WHR (general adiposity), low BMI/low WHR, and high BMI/high WHR.The researchers found that patients with higher BMI had consistently lower N-terminal pro-B-type natriuretic peptide (NT-proBNP), while no meaningful association was seen for WHR with NT-proBNP. Patients with low BMI/high WHR showed the strongest signs of congestion and the highest plasma concentrations of NT-proBNP, growth differentiation factor-15 (GDF-15), and cancer antigen-125 (CA-125); they also had a predominantly inflammatory profile and the highest risk for all-cause mortality (hazard ratio, 2.20 after adjustment for age and sex compared with those with high BMI/low WHR). The lowest levels of NT-proBNP, GDF-15, and CA-125 were seen in association with the phenotype of high BMI/low WHR. This phenotype was characterized by higher leptin levels and had the best clinical outcomes."Further longitudinal studies of changes in body composition over time are warranted, with the ultimate aim of enabling more precise risk assessment and individualized management of patients with heart failure," van der Hoef said in a statement.Press ReleaseMore Information.Sign up for our weekly HealthDay newsletter