关于肥胖,肥胖悖论和心力衰竭中的肥胖管理的最新情况
Pamela L Alebna1, Anurag Mehta1, Amin Yehya2
1Division of Cardiology, Pauley Heart Center, Department of Internal Medicine, Virginia Commonwealth University, United States of America.
Progress in cardiovascular diseases
|January 10, 2024
概括
肥胖是心力衰竭 (HF) 的一个主要危险因素. 虽然肥胖悖论表明HF的生存率更高,但心肺呼吸能力 (CRF) 可能是一个比减肥更重要的治疗目标.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 肥胖是一个全球公共卫生危机,增加心血管疾病 (CVD) 风险,不成比例地影响较低社会经济群体.
- 肥胖是心力衰竭 (HF) 的一个重要危险因素,特别是心力衰竭与保留射出分数 (HFpEF) 的心力衰竭.
- 在HF患者中观察到一种"肥胖悖论",即尽管住院率较高,但肥胖与更好的短期到中期生存相关.
研究的目的:
- 审查当前的肥胖趋势及其与心力衰竭的联系.
- 更新心力衰竭中的肥胖悖论,并批评身体质量指数 (BMI) 的使用.
- 探索治疗策略,包括体重减轻和心肺健康 (CRF) 对于肥胖的HF患者.
主要方法:
- 关于肥胖,心力衰竭和肥胖悖论的现有文献的叙事综述.
- 分析身体质量指数 (BMI) 在评估HF患者的身体组成时的局限性.
- 讨论心肺呼吸能力 (CRF) 作为潜在的风险修饰因素和治疗目标.
主要成果:
- 在HF中,肥胖悖论可能受到能量储备,年轻人群,治疗耐受性和营养状况等因素的影响.
- 身体质量指数 (BMI) 是一个不足的衡量HF由于潜在的液体过载和无法区分无脂肪质量.
- 心血管健康 (CRF) 是功能能力的更好的预测指标,当考虑时,可能会否定肥胖悖论.
结论:
- 改善心肺呼吸能力 (CRF) 可能比减肥更重要,用于管理肥胖个体心力衰竭.
- 重新思考BMI的作用,并专注于功能能力标志物,如CRF对于优化HF治疗至关重要.
- 综合治疗方法结合HF管理,体重控制和CRF增强对于这种患者群体至关重要.
更多相关视频
06:28A Chronic High-Intensity Interval Training and Diet-Induced Obesity Model to Maximize Exercise Effort and Induce Physiologic Changes in Rats
Published on: April 28, 2023
858
07:09A Surgical Model of Heart Failure with Preserved Ejection Fraction in Tibetan Minipigs
Published on: February 18, 2022
1.9K
相关概念视频
01:17Pathophysiology of Heart Failure
1.6K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
01:24Obesity
505
The Body Mass Index (BMI) is a numerical value derived from a person's weight and height, used to categorize individuals into weight ranges. It is calculated using the formula: weight in kilograms divided by height in meters squared. Obesity is a health condition characterized by excessive accumulation of adipose tissue that poses health risks, often diagnosed with a BMI ≥ 30. This excess fat storage occurs when surplus dietary calories are converted into triglycerides and stored in...
505
01:22Heart Failure Drugs: Diuretics
384
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
384
01:22Heart Failure Drugs: β-Blockers
341
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
341
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
432
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
432
01:26Heart Failure Drugs: Inotropic Agents
591
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
591