Based on the aforementioned studies showing worse outcomes in heart failure with AP, and increased severity with visceral fat,14,15,16 pancreatic lipase elevation,1,2 and NEFA elevation,3,4 we first studied an acute heart failure model in obese mice using doxorubicin, based on its rapid onset,54 its clinical relevance,46,47,48,49,50,51,52,53 worsening with obesity,55 poorly understood variable outcomes, and induction without preexisting heart failure.50 This evidence concerns the gene PNLIP and alkaline phosphatase measurement.