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Obesity and Cardiac Remodeling in Adults: Mechanisms and Clinical Implications

Martin A Alpert1, Kamalesh Karthikeyan1, Obai Abdullah1

  • 1Division of Cardiovascular Medicine, University of Missouri School of Medicine, Columbia, MO, USA.

Progress in Cardiovascular Diseases
|July 11, 2018
PubMed

Insights

Severe obesity causes hemodynamic changes and cardiac alterations, potentially leading to heart failure. Neurohormonal and metabolic factors common in obesity significantly impact heart structure and function.

Area of Science:

  • Cardiology
  • Metabolic Disorders
  • Obesity Research

Background:

  • Severe obesity induces significant hemodynamic alterations.
  • Cardiac changes include high output state, left ventricular hypertrophy, and diastolic dysfunction.
  • Right heart issues can arise from left ventricular failure, hypercirculation, and sleep-disordered breathing.

Purpose of the Study:

  • To review the mechanisms linking obesity-related neurohormonal and metabolic changes to cardiac structure and function.
  • To elucidate how these factors contribute to heart failure development in obese individuals.

Main Methods:

  • Review of experimental and human studies.
  • Analysis of neurohormonal pathways (renin-angiotensin-aldosterone, sympathetic nervous system).
  • Examination of metabolic factors (leptin resistance, adiponectin, insulin resistance, lipotoxicity).

Main Results:

  • Obesity commonly involves activated renin-angiotensin-aldosterone and sympathetic nervous systems.
  • Leptin resistance, low adiponectin, insulin resistance, and potential cardiac lipotoxicity are prevalent.
  • These factors contribute to cardiac adaptations and maladaptations.

Conclusions:

  • Neurohormonal and metabolic alterations in obesity play a crucial role in cardiac structural and functional changes.
  • These obesity-associated factors promote the development of heart failure.

Keywords:
Cardiac outputLeft ventricular diastolic dysfunctionLeft ventricular hypertrophyMetabolic abnormalitiesNeurohormonal abnormalitiesObesitySleep disordered breathing

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