Obesity cardiomyopathy: diagnosis and therapeutic implications.
Obesity is associated with an increased risk of heart failure. Apparently healthy obese individuals can, however, exhibit subclinical left ventricular dysfunction. The use of myocardial imaging techniques to detect this subclinical change could have important management implications with respect to initiating prophylactic therapy. In this Review, we evaluate possible pharmacologic and nonpharmacologic strategies for treating obesity cardiomyopathy in the context of currently understood mechanisms, including myocardial remodeling and small vessel disease, and more speculative mechanisms such as insulin resistance, and activation of the renin-angiotensin-aldosterone and sympathetic nervous systems.
Wong
Chiew
C
Alfred Hospital and the Baker Heart Research Institute, Melbourne, Australia.
Marwick
Thomas H
TH
D000818:Animals; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D050110:Bariatric Surgery; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006333:Heart Failure / Q000209:etiology*; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D009765:Obesity / Q000150:complications* / Q000628:therapy; D012084:Renin-Angiotensin System / Q000502:physiology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015431:Weight Loss / Q000502:physiology
D019440:Anti-Obesity Agents; D020097:Natriuretic Peptide, Brain