Elsevier

JACC: Heart Failure

Volume 1, Issue 2, April 2013, Pages 93-102
JACC: Heart Failure

State-of-the-Art Paper
Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure

https://doi.org/10.1016/j.jchf.2013.01.006Get rights and content
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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.

Key Words

heart failure
obesity
obesity paradox
overweight

Abbreviations and Acronyms

BMI
body mass index
BP
blood pressure
CHD
coronary heart disease
CPX
cardiopulmonary exercise testing
CV
cardiovascular
HF
heart failure
HT
heart transplantation
HTN
hypertension
LV
left ventricular
LVAD
left ventricular assist device
LVH
left ventricular hypertrophy
MCS
mechanical circulatory support
O2
oxygen
RAAS
renin-angiotensin-aldosterone system
RV
right ventricular
VE/VCo2
minute ventilation/carbon dioxide production
Vo2
oxygen consumption

Cited by (0)

Dr. Mehra has been a consultant for Johnson & Johnson, Abbott Vascular, Boston Scientific, St. Jude, Medtronic, and the National Heart, Lung, and Blood Institute of the National Institutes of Health; and has been an Officer of the HFSA and ISHLT. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.