title: The paradox of obesity cardiomyopathy and the potential for weight loss as a therapy.
abstract: Obesity is an independent risk factor for developing heart failure and the combination of the two disease states will prove to be a significant health burden over the coming years. Obesity is likely to contribute to the development of heart failure through a variety of mechanisms, including structural and functional changes, lipotoxicity and steatosis and altered substrate selection. However, once heart failure has developed, it seems that obesity confers a beneficial influence on prognosis in what has been termed the 'obesity paradox'. This may be a statistical phenomenon, but it should be considered that there is truly a protective state in the physiology of obesity. There is little evidence regarding the impact of weight loss in obese heart failure and whether or not this is beneficial. There have been small studies regarding the cardiovascular effects of both dietary weight loss and bariatric surgery, but few in heart failure. This is an important and increasingly relevant clinical question which must be addressed.
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: J J
authors.initials: JJ
authors.lastname: Rayner
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: S
authors.initials: S
authors.lastname: Neubauer
authors.affiliation: Oxford Centre for Clinical Magnetic Resonance Research, Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
authors.forename: O J
authors.initials: OJ
authors.lastname: Rider
mesh_terms: D015992:Body Mass Index; D009202:Cardiomyopathies / Q000150:complications* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006333:Heart Failure / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: Cardiomyopathy; heart failure; myocardial energetics; obesity paradox