Cardiac Effects of Obesity: PATHOPHYSIOLOGIC, CLINICAL, AND PROGNOSTIC CONSEQUENCES-A REVIEW

Area of Science:

• Cardiology
• Metabolic Disorders
• Exercise Physiology

Background:

• Obesity is linked to hemodynamic changes and cardiac remodeling, increasing risk for ventricular dysfunction and heart failure (HF).
• Obesity negatively impacts cardiorespiratory fitness, a key factor in overall health.
• A notable 'obesity paradox' suggests better outcomes for overweight/mildly obese individuals with HF compared to normal-weight individuals.

Purpose of the Study:

• To explore the complex relationship between obesity, cardiac function, and prognosis in heart failure.
• To investigate the role of cardiorespiratory fitness in obesity and its impact on heart failure outcomes.
• To assess the potential for reversing obesity-induced cardiac alterations through weight loss.

Main Methods:

• Review of existing literature on obesity, hemodynamics, cardiac morphology, and heart failure.
• Analysis of studies examining cardiorespiratory fitness in obese populations.
• Evaluation of research on the effects of weight loss interventions on cardiac structure and function in obesity.

Main Results:

• Obesity contributes to cardiac dysfunction and heart failure, acting as a risk factor or primary cause.
• Overweight and mildly to moderately obese individuals with HF exhibit a survival advantage (obesity paradox).
• Cardiorespiratory fitness is a critical prognostic indicator in obesity.
• Substantial weight loss can reverse cardiac structural and functional abnormalities in moderately to severely obese individuals.

Conclusions:

• Obesity presents a dual challenge in heart failure: increased risk and a paradoxical survival benefit in certain weight categories.
• Cardiorespiratory fitness is a crucial modifiable factor influencing prognosis in obesity.
• Weight reduction offers a viable strategy for mitigating and potentially reversing cardiac complications associated with obesity.