Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 May 13

PMID 37176781

Authors

Jason Stencel

Hamid R Alai

Aneesh Dhore-Patil

Daniela Urina-Jassir

Thierry H Le Jemtel

Affiliations

Soon will be listed here.

Abstract

Owing to the overwhelming obesity epidemic, preserved ejection fraction heart failure commonly ensues in patients with severe obesity and the obese phenotype of preserved ejection fraction heart failure is now commonplace in clinical practice. Severe obesity and preserved ejection fraction heart failure share congruent cardiovascular, immune, and renal derangements that make it difficult to ascertain whether the obese phenotype of preserved ejection fraction heart failure is the convergence of two highly prevalent conditions or severe obesity enables the development and progression of the syndrome of preserved ejection fraction heart failure. Nevertheless, the obese phenotype of preserved ejection fraction heart failure provides a unique opportunity to assess whether sustained and sizeable loss of excess body weight via metabolic bariatric surgery reverses the concentric left ventricular remodeling that patients with preserved ejection fraction heart failure commonly display.

Citing Articles

Association of visceral adiposity index (VAI) with prognosis in patients with metabolic syndrome and heart failure with reduced ejection fraction.

Wu M, Lai W, Huo X, Wang Q, Zhou Y, Gao D BMC Cardiovasc Disord. 2025; 25(1):160.

PMID: 40055587 PMC: 11887152. DOI: 10.1186/s12872-025-04591-1.

Challenges in the diagnosis of heart failure with preserved ejection fraction in individuals with obesity.

van Dalen B, Chin J, Motiram P, Hendrix A, Emans M, Brugts J Cardiovasc Diabetol. 2025; 24(1):71.

PMID: 39920805 PMC: 11806779. DOI: 10.1186/s12933-025-02612-z.

Retrospective Study on Short-Term Reverse Cardiac Remodeling in Obese Patients Undergoing Sleeve Gastrectomy.

Izzo C, Visco V, Cirillo A, Bonadies D, Caliendo G, Rusciano M J Cardiovasc Dev Dis. 2024; 11(12).

PMID: 39728279 PMC: 11676178. DOI: 10.3390/jcdd11120389.

Epicardial Adipose Tissue Thickness and Preserved Ejection Fraction Heart Failure.

Dhore-Patil A, Urina-Jassir D, Samson R, Le Jemtel T, Oparil S Curr Hypertens Rep. 2024; 26(9):381-388.

PMID: 38642285 PMC: 11324708. DOI: 10.1007/s11906-024-01302-7.

Effect of on left ventricular remodeling in HFrEF: a systematic review and meta-analysis.

Han X, Yu T, Chen X, Du Z, Yu M, Xiong J Front Pharmacol. 2024; 15:1345797.

PMID: 38283626 PMC: 10811102. DOI: 10.3389/fphar.2024.1345797.

References

Katz S, Maskin C, Jondeau G, Cocke T, Berkowitz R, Lejemtel T . Near-maximal fractional oxygen extraction by active skeletal muscle in patients with chronic heart failure. J Appl Physiol (1985). 2000; 88(6):2138-42. DOI: 10.1152/jappl.2000.88.6.2138. View

Kitzman D, Brubaker P, Morgan T, Haykowsky M, Hundley G, Kraus W . Effect of Caloric Restriction or Aerobic Exercise Training on Peak Oxygen Consumption and Quality of Life in Obese Older Patients With Heart Failure With Preserved Ejection Fraction: A Randomized Clinical Trial. JAMA. 2016; 315(1):36-46. PMC: 4787295. DOI: 10.1001/jama.2015.17346. View

Bello N, Cheng S, Claggett B, Shah A, Ndumele C, Roca G . Association of Weight and Body Composition on Cardiac Structure and Function in the ARIC Study (Atherosclerosis Risk in Communities). Circ Heart Fail. 2016; 9(8). PMC: 5218510. DOI: 10.1161/CIRCHEARTFAILURE.115.002978. View

Saltiel A, Olefsky J . Inflammatory mechanisms linking obesity and metabolic disease. J Clin Invest. 2017; 127(1):1-4. PMC: 5199709. DOI: 10.1172/JCI92035. View

Cypess A . Reassessing Human Adipose Tissue. N Engl J Med. 2022; 386(8):768-779. DOI: 10.1056/NEJMra2032804. View

Yang J, Obokata M, Reddy Y, Redfield M, Lerman A, Borlaug B . Endothelium-dependent and independent coronary microvascular dysfunction in patients with heart failure with preserved ejection fraction. Eur J Heart Fail. 2019; 22(3):432-441. DOI: 10.1002/ejhf.1671. View

Saavedra-Alvarez A, Pereyra K, Toledo C, Iturriaga R, Del Rio R . Vascular dysfunction in HFpEF: Potential role in the development, maintenance, and progression of the disease. Front Cardiovasc Med. 2023; 9:1070935. PMC: 9810809. DOI: 10.3389/fcvm.2022.1070935. View

Pi X, Xie L, Patterson C . Emerging Roles of Vascular Endothelium in Metabolic Homeostasis. Circ Res. 2018; 123(4):477-494. PMC: 6205216. DOI: 10.1161/CIRCRESAHA.118.313237. View

Hall J, do Carmo J, da Silva A, Wang Z, Hall M . Obesity, kidney dysfunction and hypertension: mechanistic links. Nat Rev Nephrol. 2019; 15(6):367-385. PMC: 7278043. DOI: 10.1038/s41581-019-0145-4. View

10.

Wang M, Wang Z, Chen Y, Dong Y . Kidney Damage Caused by Obesity and Its Feasible Treatment Drugs. Int J Mol Sci. 2022; 23(2). PMC: 8775419. DOI: 10.3390/ijms23020747. View

11.

Ndumele C, Cobb L, Lazo M, Bello N, Shah A, Nambi V . Weight History and Subclinical Myocardial Damage. Clin Chem. 2017; 64(1):201-209. PMC: 6219376. DOI: 10.1373/clinchem.2017.282798. View

12.

Fliotsos M, Zhao D, Rao V, Ndumele C, Guallar E, Burke G . Body Mass Index From Early-, Mid-, and Older-Adulthood and Risk of Heart Failure and Atherosclerotic Cardiovascular Disease: MESA. J Am Heart Assoc. 2018; 7(22):e009599. PMC: 6404455. DOI: 10.1161/JAHA.118.009599. View

13.

Mazzotta C, Basu S, Gower A, Karki S, Farb M, Sroczynski E . Perivascular Adipose Tissue Inflammation in Ischemic Heart Disease. Arterioscler Thromb Vasc Biol. 2021; 41(3):1239-1250. PMC: 7904602. DOI: 10.1161/ATVBAHA.120.315865. View

14.

Haidar A, Taegtmeyer H . Strategies for Imaging Metabolic Remodeling of the Heart in Obesity and Heart Failure. Curr Cardiol Rep. 2022; 24(4):327-335. PMC: 9074778. DOI: 10.1007/s11886-022-01650-3. View

15.

Wong C, OMoore-Sullivan T, Leano R, Hukins C, Jenkins C, Marwick T . Association of subclinical right ventricular dysfunction with obesity. J Am Coll Cardiol. 2006; 47(3):611-6. DOI: 10.1016/j.jacc.2005.11.015. View

16.

Stienstra R, Tack C, Kanneganti T, Joosten L, Netea M . The inflammasome puts obesity in the danger zone. Cell Metab. 2012; 15(1):10-8. DOI: 10.1016/j.cmet.2011.10.011. View

17.

Rizzoni D, De Ciuceis C, Szczepaniak P, Paradis P, Schiffrin E, Guzik T . Immune System and Microvascular Remodeling in Humans. Hypertension. 2022; 79(4):691-705. DOI: 10.1161/HYPERTENSIONAHA.121.17955. View

18.

Lindhorst A, Raulien N, Wieghofer P, Eilers J, Rossi F, Bechmann I . Adipocyte death triggers a pro-inflammatory response and induces metabolic activation of resident macrophages. Cell Death Dis. 2021; 12(6):579. PMC: 8179930. DOI: 10.1038/s41419-021-03872-9. View

19.

Donini L, Poggiogalle E, Mosca V, Pinto A, Brunani A, Capodaglio P . Disability affects the 6-minute walking distance in obese subjects (BMI>40 kg/m(2)). PLoS One. 2013; 8(10):e75491. PMC: 3795729. DOI: 10.1371/journal.pone.0075491. View

20.

Steinberg H, Chaker H, LEAMING R, Johnson A, Brechtel G, Baron A . Obesity/insulin resistance is associated with endothelial dysfunction. Implications for the syndrome of insulin resistance. J Clin Invest. 1996; 97(11):2601-10. PMC: 507347. DOI: 10.1172/JCI118709. View