Complex cardiac remodelling patterns may result in obesity from different stimuli, including haemodynamic loading conditions, obesity-associated pro-inflammatory factors, glucotoxicity, lipotoxicity, and leptin-resistance.39 The unique shape associated with obesity may serve as a biomarker that could identify those at highest risk for later CVD, including obesity-associated heart failure (the ‘obesity cardiomyopathy’). Here, LEP is linked to obesity due to melanocortin 4 receptor deficiency.