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Should We Target Obesity in Advanced Heart Failure?

  • Heart Failure (W Tang, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Opinion statement

Obesity is a risk factor for the development of heart failure (HF), but has been associated with improved survival in patients with established HF. Weight loss should clearly be recommended and supported for obese individuals without cardiac pathology to prevent cardiomyopathy development. Clinical recommendations at the other end of the obesity heart failure spectrum are also relatively clear. Morbidly obese individuals (BMI ≥ 40 kg/m2) aged <50 years with severely depressed systolic function and NYHA class III-IV symptoms should be considered for malabsorptive bariatric surgery at an experienced center. The goal is either improved systolic function and symptoms, or sufficient weight loss for heart transplant eligibility. Recommendations for patients falling between these extremes are more challenging. Overweight and mildly obese HF patients (25–35 kg/m2) may be somewhat protected from cardiac cachexia and weight loss is not expected to enhance survival, but may offer symptomatic benefits.

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References and Recommended Reading

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Conflict of Interest

Dr. Amanda R Vest received travel/accommodations expenses covered or reimbursed by the American Heart Association and is employed by the Cleveland Clinic. Dr. James B Young declares that he has no conflicts of interest. The authors did not receive funding for this work, and they have no financial relationships or other industry disclosures to make.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Heart and Vascular Institute, Section of Heart Failure, 9500 Euclid Avenue, Mail Code J3-4, Cleveland, OH, 44195, USA

    Amanda R. Vest MBBS & James B. Young MD

  2. Endocrinology and Metabolism Institute, Cleveland Clinic Main Campus, 9500 Euclid Avenue, Mail Code NA21, Cleveland, OH, 44195, USA

    James B. Young MD

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  1. Amanda R. Vest MBBS
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  2. James B. Young MD
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Correspondence to Amanda R. Vest MBBS.

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This article is part of the Topical Collection on Heart Failure

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Vest, A.R., Young, J.B. Should We Target Obesity in Advanced Heart Failure?. Curr Treat Options Cardio Med 16, 284 (2014). https://doi.org/10.1007/s11936-013-0284-z

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  • DOI: https://doi.org/10.1007/s11936-013-0284-z

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