Cardiometabolic Syndrome and Increased Risk of Heart Failure
Helene von Bibra1, Walter Paulus2, Martin St John Sutton3
1Clinic for Endocrinology, Diabetes & Vascular Medicine, Klinikum Bogenhausen, Städt. Klinikum München GmbH, Munich, Germany. vonbibra@gmx.de.
Insights
Diastolic heart failure (HFPEF) affects 50% of heart failure patients, often linked to metabolic issues. Dietary therapy shows promise for managing cardiometabolic syndrome and improving heart function without weight loss.
Area of Science:
- Cardiology
- Metabolic Syndrome Research
- Biomathematics
Background:
- Diastolic heart failure with preserved ejection fraction (HFPEF) accounts for approximately 50% of heart failure cases.
- Major risk factors include age, inactivity, obesity, insulin resistance (IR), type-2 diabetes, and hypertension.
- HFPEF shares comparable prognosis with systolic heart failure but lacks specific effective treatments.
Purpose of the Study:
- To present a biomathematically corrected diagnostic approach for quantifying diastolic dysfunction (DD) using age-dependent diastolic function.
- To explore pathophysiological mechanisms of DD within the cardiometabolic syndrome (CMS), focusing on IR's impact on myocardial energy supply.
- To discuss therapeutic strategies for CMS, IR, and associated DD/HFPEF, emphasizing dietary interventions.
Main Methods:
- Biomathematical correction applied to diagnostic criteria for diastolic dysfunction.
- Review of pathophysiological mechanisms linking insulin resistance to diastolic dysfunction in cardiometabolic syndrome.
- Analysis of therapeutic strategies, with a focus on dietary interventions for CMS and HFPEF.
Main Results:
- A novel diagnostic approach for DD quantification based on age-related diastolic function is proposed.
- Insulin resistance-induced insufficient myocardial energy supply is identified as a key mechanism for DD in CMS.
- Dietary therapy demonstrates potential for improving CMS manifestations and reducing cardiovascular risk, independent of weight loss.
Conclusions:
- Effective diagnosis and management of HFPEF, particularly related to cardiometabolic syndrome, are critical.
- A biomathematical approach offers improved quantification of diastolic dysfunction.
- Dietary interventions represent a promising therapeutic avenue for managing CMS, IR, and HFPEF.
Abstract:
Approximately 50 % of patients with heart failure have diastolic heart failure (HFPEF) with the major predisposing risk factors age, inactivity, obesity, insulin resistance (IR), type-2 diabetes, and hypertension. The prognosis of HFPEF is comparable to that of systolic heart failure, but without any specific or effective treatment. This review presents a biomathematically corrected diagnostic approach for quantification of diastolic dysfunction (DD) via the age dependency of diastolic function. Pathophysiological mechanisms for DD in the cardiometabolic syndrome (CMS) are mainly based on downstream effects of IR including insufficient myocardial energy supply. The second section discusses therapeutic strategies for the control and therapy of CMS, IR, and the associated DD/HFPEF with a focus on dietary therapy that is independent of weight loss but improves all manifestations of the CMS and reduces cardiovascular risk.
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