Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure
Impact of Obesity and the Obesity Paradox on Prevalence and Prognosis in Heart Failure
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DOI：
10.1016/j.jchf.2013.01.006
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发表时间：
2013-04-01
影响因子：
13
通讯作者：
Ventura, Hector O.
中科院分区：
文献类型：
--
作者：
Lavie, Carl J.;Alpert, Martin A.;Ventura, Hector O.
肥胖在美国和全世界已经达到流行病的程度。考虑到肥胖对左心室（LV）结构、舒张和收缩功能以及心力衰竭（HF）的其他危险因素（包括高血压和冠心病）的不良影响，肥胖患者的HF发病率和患病率明显增加，这并不奇怪。然而，与大多数其他心血管疾病一样，许多研究已经证明了肥胖悖论，其中超重和肥胖患者（由体重指数，体脂百分比或中心性肥胖定义）与瘦或体重不足的HF患者相比表现出更好的预后。本综述将描述心力衰竭患者心肺运动试验中肥胖的相关数据。此外，肥胖对左心室辅助装置和心脏移植的影响进行了综述。最后，尽管存在肥胖悖论，我们还是讨论了HF患者体重减轻的现状。(C)2013年美国心脏病学会基金会
Obesity has reached epidemic proportions in the United States and worldwide. Considering the adverse effects of obesity on left ventricular (LV) structure, diastolic and systolic function, and other risk factors for heart failure (HF), including hypertension and coronary heart disease, HF incidence and prevalence, not surprisingly, is markedly increased in obese patients. Nevertheless, as with most other cardiovascular diseases, numerous studies have documented an obesity paradox, in which overweight and obese patients, defined by body mass index, percent body fat, or central obesity, demonstrate a better prognosis compared with lean or underweight HF patients. This review will describe the data on obesity in the context of cardiopulmonary exercise testing in HF. Additionally, the implications of obesity on LV assist devices and heart transplantation are reviewed. Finally, despite the obesity paradox, we address the current state of weight reduction in HF. (C) 2013 by the American College of Cardiology Foundation