Obesity and heart failure: epidemiology, pathophysiology, clinical manifestations, and management

• Published in: Translational research : the journal of laboratory and clinical medicine Vol. 164; no. 4; pp. 345 - 356
• Main Authors: Alpert, Martin A, Lavie, Carl J, Agrawal, Harsh, Aggarwal, Kul B, Kumar, Senthil A
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2014
• Subjects: Algorithms; Cardiomyopathies - classification; Cardiomyopathies - etiology; Cardiomyopathies - mortality; Cardiomyopathies - physiopathology; Heart Failure - etiology; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Humans; Internal Medicine; Obesity - complications; coronary artery disease; HTN; RV; RAAS; LVEF; LV; left ventricular ejection fraction; SVR; cardiac output; LVEDP; left ventricular or left ventricle; CBV; right ventricular or right ventricle; BMI; systemic vascular resistance; WHO; heart failure; QTc; corrected QT interval; central blood volume; SV; World Health Organization; body mass index; CAD; left ventricular end-diastolic pressure; CO; cardiovascular; stroke volume; CV; left ventricular hypertrophy; renin angiotensin-aldosterone system; hypertension; HF; LVH
• ISSN: 1931-5244; 1878-1810
• DOI: 10.1016/j.trsl.2014.04.010

Obesity is a risk factor for heart failure (HF) in both men and women. The mortality risk of overweight and class I and II obese adults with HF is lower than that of normal weight or underweight adults with HF of comparable severity, a phenomenon referred to as the obesity paradox. Severe obesity produces hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function, which may lead to the development of HF. The presence of systemic hypertension, sleep apnea, and hypoventilation, comorbidities that occur commonly with severe obesity, may contribute to HF in such patients. The resultant syndrome is known as obesity cardiomyopathy. Substantial weight loss in severely obese persons is capable of reversing most obesity-related abnormalities of cardiac performance and morphology and improving the clinical manifestations of obesity cardiomyopathy.