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Weight Reduction for Obesity-Induced Heart Failure with Preserved Ejection Fraction

  • Hypertension and Obesity (E Reisin, Section Editor)
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Abstract

Purpose of Review

Heart failure with preserved ejection fraction mainly affects the elderly. The obesity phenotype of heart failure with preserved ejection fraction reflects the coexistence of two highly prevalent conditions in the elderly. Obesity may also lead to heart failure with preserved ejection fraction in middle-aged persons, especially in African American women.

Recent Findings

Obesity is twice as common in middle-aged than in elderly persons with heart failure with preserved ejection fraction. Obese middle-aged persons with heart failure with preserved ejection fraction are less likely to be Caucasian and to have atrial fibrillation or chronic kidney disease as comorbidities than elderly patients with heart failure with preserved ejection fraction. Obesity-associated low-grade systemic inflammation may induce/heighten inflammatory activation of the coronary microvascular endothelium, leading to cardiomyocyte hypertrophy/ stiffness, myocardial fibrosis, and left ventricular diastolic dysfunction.

Summary

Both substantial weight reduction with bariatric surgery and lesser levels of weight reduction with caloric restriction are promising therapeutic approaches to obesity-induced heart failure with preserved ejection fraction.

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Authors and Affiliations

  1. Tulane University Heart and Vascular Institute, 1430 Tulane Ave, SL-48, New Orleans, LA, 70112, USA

    Karnika Ayinapudi, Rohan Samson, Thierry H. Le Jemtel & Nassir F. Marrouche

  2. Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, LA, USA

    Suzanne Oparil

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Ayinapudi, K., Samson, R., Le Jemtel, T.H. et al. Weight Reduction for Obesity-Induced Heart Failure with Preserved Ejection Fraction. Curr Hypertens Rep 22, 47 (2020). https://doi.org/10.1007/s11906-020-01074-w

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