In contrast, circulating levels of adiponectin are markedly reduced in obese HFpEF patients, particularly in women (73), and it has been suggested that adiponectin may prevent some of the pathophysiologic mechanisms underlying the obese-HFpEF such as myocardial hypertrophy, cardiac fibrosis, oxidative stress, and inflammation (44, 60). This evidence concerns the gene ADIPOQ and cardiac hypertrophy.