Proactive heart failure screening in obesity: design, recruitment, and baseline characteristics of the SCORHFE trial

Background: Obesity is strongly associated with heart failure (HF), but recognition remains challenging in primary care because symptoms, physical findings, and natriuretic peptide concentrations may be difficult to interpret. Objectives: To describe the design, recruitment, baseline characteristics, and acceptability of a trial evaluating proactive multimodal HF screening in adults with obesity. Methods: Adults aged 45 years or older with obesity and no known cardiac disease were randomized 1:1 to proactive multimodal HF screening or usual care. Screening comprised medical history, physical examination, blood sampling, 12-lead electrocardiography, and transthoracic echocardiography. The primary endpoint is left ventricular dysfunction and/or acute HF hospitalization at 1 year. Results: Between March 2024 and June 2025, 746 individuals expressed interest, 629 (84.3%) underwent eligibility assessment, and 420 were randomized. Mean age was 58.3 ± 8.4 years, 295 participants (70.2%) were women, and median body mass index was 35.0 [32.4–38.0] kg/m2. Among 385 participants with available waist circumference data, 379 (98.4%) had central obesity. Ninety-seven participants (23.1%) had two or more cardiometabolic conditions. Among a random subset of 50 screened participants, 46 (92.0%) considered screening duration acceptable, 47 (94.0%) reported low procedural burden, and 46 (92.0%) supported routine implementation. Conclusions: Recruitment through primary care obesity pathways reached adults with substantial adiposity and cardiometabolic burden. Screening acceptability was high in a random subset. One-year follow-up will determine clinical and economic effects. Trial registration number: NCT06137261. © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.