The present study has two major findings: I) In obese patients, the diagnosis of HF was neither associated with increased plasma concentrations of NT-proBNP or MR-proANP nor with increased plasma concentrations of MR-proADM or copeptin, suggesting an overall impaired neurohormonal activation in obesity-related HF. Here, AVP is linked to obesity due to melanocortin 4 receptor deficiency.