Heart failure (HF) represents a complex cardiovascular disease with a wide range of risk factors, different pathophysiology, and various manifestations. Obesity is one of the most important comorbidities and one of the risk factors in HF patients. It seems that obesity has a more important role in development of HF patients with preserved left ventricular ejection fraction (HFpEF) than in HF patients with reduced ejection fraction (HFrEF). The role of obesity on HF with mid-range ejection fraction (HFmrEF) is a matter of debate. The impact of obesity on outcome in HF patients is still unclear. The relationship varies from the linear to the U-shaped. The "obesity paradox, " which suggests the reduced risk in mildly overweight subjects in comparison with normal-and underweight individuals, drew significant attention. The mechanisms that relate obesity and HF vary from obesity-induced hemodynamic changes to biohumoral systems such as adipocytokines, renin-angiotensin-aldosterone and sympathetic nervous systems, natriuretic peptide, and oxidative stress. In the absence of a satisfactory pharmacological approach, which would improve the outcome of this large group of patients, alternative methods such as weight loss and physical activity seem to provide encouraging results.
Tadic, M., Cuspidi, C. (2020). Heart Failure and the Obesity Paradox. In J. Faintuch, S. Faintuch (a cura di), Obesity and Diabetes: Scientific Advances and Best Practice (pp. 427-435). Springer International Publishing [10.1007/978-3-030-53370-0_31].
Heart Failure and the Obesity Paradox
Cuspidi C
2020
Abstract
Heart failure (HF) represents a complex cardiovascular disease with a wide range of risk factors, different pathophysiology, and various manifestations. Obesity is one of the most important comorbidities and one of the risk factors in HF patients. It seems that obesity has a more important role in development of HF patients with preserved left ventricular ejection fraction (HFpEF) than in HF patients with reduced ejection fraction (HFrEF). The role of obesity on HF with mid-range ejection fraction (HFmrEF) is a matter of debate. The impact of obesity on outcome in HF patients is still unclear. The relationship varies from the linear to the U-shaped. The "obesity paradox, " which suggests the reduced risk in mildly overweight subjects in comparison with normal-and underweight individuals, drew significant attention. The mechanisms that relate obesity and HF vary from obesity-induced hemodynamic changes to biohumoral systems such as adipocytokines, renin-angiotensin-aldosterone and sympathetic nervous systems, natriuretic peptide, and oxidative stress. In the absence of a satisfactory pharmacological approach, which would improve the outcome of this large group of patients, alternative methods such as weight loss and physical activity seem to provide encouraging results.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.