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Obesity and heart failure with preserved ejection fraction: A growing problem
Stuart B Prenner1, Paul J Mather1
1Department of Medicine, Cardiovascular Division, University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Trends in Cardiovascular Medicine
|January 7, 2018
Summary
Obesity is common in heart failure with preserved ejection fraction (HFpEF), potentially indicating a distinct HFpEF phenotype. Further research is crucial for effective treatments in this growing obese HFpEF population.
Area of Science:
- Cardiology
- Obesity Medicine
- Translational Research
Background:
- Heart Failure with Preserved Ejection Fraction (HFpEF) prevalence is rising, linked to an aging population and obesity epidemic.
- Obesity is highly prevalent in HFpEF patients, suggesting a specific phenotype with unique hemodynamic and structural characteristics.
- Obesity triggers systemic inflammation, potentially causing myocardial fibrosis and endothelial dysfunction, key factors in HFpEF pathogenesis.
Purpose of the Study:
- To explore the specific phenotype of HFpEF in obese patients.
- To highlight the impact of obesity-induced systemic inflammation on myocardial fibrosis and endothelial dysfunction.
- To emphasize the need for clinical trials including severely obese patients to determine optimal pharmacologic and interventional strategies.
Main Methods:
- Review of current literature on HFpEF and obesity.
- Analysis of the pathophysiological mechanisms linking obesity to HFpEF.
- Identification of gaps in current clinical trial populations regarding obesity.
Main Results:
- Obesity presents a distinct HFpEF phenotype with specific hemodynamic and structural abnormalities.
- Systemic inflammation driven by obesity contributes to myocardial fibrosis and endothelial dysfunction in HFpEF.
- Severely obese patients are underrepresented in current HFpEF clinical trials.
Conclusions:
- Obesity represents a critical phenotype within HFpEF requiring targeted research.
- Understanding the inflammatory pathways in obese HFpEF is essential for developing new therapies.
- Future research and clinical trials must include the growing population of obese HFpEF patients to advance treatment options.
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