Obesity, inflammation, and heart failure: links and misconceptions

Area of Science:

• Cardiology
• Metabolic Syndrome
• Inflammation Research

Background:

• Obesity is associated with heart failure with preserved left ventricular ejection fraction (HFpEF).
• This association is often attributed to metabolic and inflammatory changes induced by obesity.
• Heart failure (HF) is a complex syndrome with diverse phenotypes beyond left ventricular ejection fraction (LVEF).

Purpose of the Study:

• To explore the relationship between obesity and the spectrum of heart failure phenotypes.
• To investigate the role of systemic inflammation in connecting obesity with different HF types.
• To emphasize that obesity's impact on HF extends beyond the LVEF classification.

Main Methods:

• Review of existing literature on obesity, inflammation, and heart failure phenotypes.
• Analysis of the systemic pro-inflammatory state across the heart failure spectrum.
• Comparison of HFpEF and HF with reduced LVEF (HFrEF) in the context of obesity and inflammation.

Main Results:

• A systemic pro-inflammatory state is present throughout the entire spectrum of heart failure.
• Obesity is intertwined with heart failure across various phenotypes, not limited to HFpEF.
• Overlapping characteristics exist between HFpEF and HFrEF, influenced by systemic inflammation.

Conclusions:

• Obesity contributes to heart failure through systemic inflammation, affecting all HF phenotypes.
• The LVEF construct is insufficient to fully capture the relationship between obesity and HF.
• Understanding the systemic inflammatory component is crucial for managing obesity-related heart failure.