Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure

Obesity has reached epidemic proportions in the United States and worldwide. Considering the adverse effects of obesity on left ventricular (LV) structure, diastolic and systolic function, and other risk factors for heart failure (HF), including hypertension and coronary heart disease, HF incidence...

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Bibliographic Details
Published in:JACC. Heart failure 2013-04, Vol.1 (2), p.93-102
Main Authors: Lavie, Carl J., MD, Alpert, Martin A., MD, Arena, Ross, PhD, PT, Mehra, Mandeep R., MBBS, Milani, Richard V., MD, Ventura, Hector O., MD
Format: Article
Language:English
Subjects:
Cardiovascular
heart failure
Heart Failure - complications
Heart Failure - epidemiology
Heart Ventricles - pathology
Hemodynamics
Humans
obesity
Obesity - complications
Obesity - physiopathology
Obesity - therapy
obesity paradox
overweight
Prevalence
Prognosis
Ventricular Function, Left
Weight Loss
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Description
Summary:Obesity has reached epidemic proportions in the United States and worldwide. Considering the adverse effects of obesity on left ventricular (LV) structure, diastolic and systolic function, and other risk factors for heart failure (HF), including hypertension and coronary heart disease, HF incidence and prevalence, not surprisingly, is markedly increased in obese patients. Nevertheless, as with most other cardiovascular diseases, numerous studies have documented an obesity paradox, in which overweight and obese patients, defined by body mass index, percent body fat, or central obesity, demonstrate a better prognosis compared with lean or underweight HF patients. This review will describe the data on obesity in the context of cardiopulmonary exercise testing in HF. Additionally, the implications of obesity on LV assist devices and heart transplantation are reviewed. Finally, despite the obesity paradox, we address the current state of weight reduction in HF.
ISSN:2213-1779
2213-1787
DOI:10.1016/j.jchf.2013.01.006