title: Obesity and heart failure: epidemiology, pathophysiology, clinical manifestations, and management.
abstract: Obesity is a risk factor for heart failure (HF) in both men and women. The mortality risk of overweight and class I and II obese adults with HF is lower than that of normal weight or underweight adults with HF of comparable severity, a phenomenon referred to as the obesity paradox. Severe obesity produces hemodynamic alterations that predispose to changes in cardiac morphology and ventricular function, which may lead to the development of HF. The presence of systemic hypertension, sleep apnea, and hypoventilation, comorbidities that occur commonly with severe obesity, may contribute to HF in such patients. The resultant syndrome is known as obesity cardiomyopathy. Substantial weight loss in severely obese persons is capable of reversing most obesity-related abnormalities of cardiac performance and morphology and improving the clinical manifestations of obesity cardiomyopathy.
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri, Columbia, Missouri. Electronic address: malpert815@yahoo.com.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Alpert
authors.affiliation: Department of Cardiology, John Ochsner Heart and Vascular Institute, New Orleans, Louisiana.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Harsh
authors.initials: H
authors.lastname: Agrawal
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Kul B
authors.initials: KB
authors.lastname: Aggarwal
authors.affiliation: Division of Cardiovascular Medicine, University of Missouri, Columbia, Missouri.
authors.forename: Senthil A
authors.initials: SA
authors.lastname: Kumar
mesh_terms: D000465:Algorithms; D009202:Cardiomyopathies / Q000145:classification / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D009765:Obesity / Q000150:complications*