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Author Spotlight: Exploring the Relationship Between Lipotoxicity and HFpEF
Published on: March 29, 2024
Obesity and Heart Failure with Preserved Ejection Fraction
Efstratios Koutroumpakis1, Ramanjit Kaur1, Heinrich Taegtmeyer1
1Division of Cardiology, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center, 6431 Fannin Street, MSB 1.220, Houston, TX 77030, USA.
Abstract:
Obese heart failure with preserved ejection fraction (HFpEF) is a distinct HFpEF phenotype. Sodium retention, high circulating neurohormone levels, alterations in energy substrate metabolism, group 3 pulmonary hypertension, pericardial restraint, and systemic inflammation are central pathophysiologic mechanisms. Confirming the diagnosis may be challenging and high suspicion is required. Reduction of visceral adipose tissue, via caloric restriction and/or bariatric surgery, may improve outcomes in obese HFpEF patients. Furthermore, mineralocorticoid receptor inhibition, neprilysin inhibition, and sodium-glucose cotransporter 2 inhibition can ameliorate the effects of adiposity on the cardiovascular system, allowing for promising new treatment targets for the obese HFpEF phenotype.
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