title: Cardiometabolic Syndrome and Increased Risk of Heart Failure.
abstract: Approximately 50 % of patients with heart failure have diastolic heart failure (HFPEF) with the major predisposing risk factors age, inactivity, obesity, insulin resistance (IR), type-2 diabetes, and hypertension. The prognosis of HFPEF is comparable to that of systolic heart failure, but without any specific or effective treatment. This review presents a biomathematically corrected diagnostic approach for quantification of diastolic dysfunction (DD) via the age dependency of diastolic function. Pathophysiological mechanisms for DD in the cardiometabolic syndrome (CMS) are mainly based on downstream effects of IR including insufficient myocardial energy supply. The second section discusses therapeutic strategies for the control and therapy of CMS, IR, and the associated DD/HFPEF with a focus on dietary therapy that is independent of weight loss but improves all manifestations of the CMS and reduces cardiovascular risk.
authors.affiliation: Clinic for Endocrinology, Diabetes & Vascular Medicine, Klinikum Bogenhausen, Städt. Klinikum München GmbH, Munich, Germany. vonbibra@gmx.de.
authors.forename: Helene
authors.initials: H
authors.lastname: von Bibra
authors.affiliation: Institute for Cardiovascular Research Vrije Universiteit, VU University Medical Center Amsterdam, Amsterdam, The Netherlands.
authors.forename: Walter
authors.initials: W
authors.lastname: Paulus
authors.affiliation: Department of Medicine, Cardiovascular Division, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: St John Sutton
mesh_terms: D000367:Age Factors; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004734:Energy Metabolism; D006333:Heart Failure / Q000150:complications; D054144:Heart Failure, Diastolic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D009206:Myocardium / Q000378:metabolism; D009765:Obesity / Q000150:complications; D012307:Risk Factors; D057185:Sedentary Behavior; D013318:Stroke Volume
keywords: Carbohydrate restriction; Diastolic dysfunction; HFPEF; Insulin resistance; Metabolic syndrome