Gopal DM, et al. - In young obese participants free of clinically evident cardiovascular disease, researchers evaluated GAL3 (galectin–3), FSTL3 (follistatin-like 3 peptide), and NT-proBNP (N-terminal pro-B-type natriuretic peptide) as predictors for stage B metabolic heart disease (MHD), given that obesity is a forerunner to heart failure with preserved ejection fraction. This study included 250 asymptomatic obese patients and 21 non-obese controls who had echocardiographic cardiac phenotyping. The obese patients who had abnormal diastolic function or left ventricular hypertrophy and had estimated pulmonary artery systolic pressure ≥35 mm Hg were considered as MHD positive (MHD-POS; n=94). Those with obesity and absence of such abnormalities were defined as MHD negative (MHD-NEG; n=52). The presence of preclinical MHD was identified in relation to GAL3 in young obese individuals without known cardiovascular disease. Based on these findings, preclinical MHD could be screened using GAL3 and it could have utility in detecting individuals with increased risk of progression to obesity-related heart failure with preserved ejection fraction.