Effects of diet-induced obesity on inflammation and remodeling after myocardial infarction. Am J Physiol Heart Circ Physiol 291: H2504 -H2514, 2006. First published May 26, 2006 doi:10.1152/ajpheart.00322.2006.-Epidemiological studies indicate that obesity, insulin resistance, and diabetes are important comorbidities of patients with ischemic heart disease and increase mortality and development of congestive heart failure after myocardial infarction. Although ob/ob and db/db mice are commonly used to study obesity with insulin resistance or diabetes, mutations in the leptin gene or its receptor are rarely the cause of obesity in humans, which is, instead, primarily a consequence of dietary and lifestyle factors. Therefore, we used a murine model of diet-induced obesity to examine the physiological effects of obesity and the inflammatory and healing response of diet-induced obese (DIO) mice after myocardial ischemia-reperfusion injury. DIO mice developed hyperinsulinemia and insulin resistance and hepatic steatosis, with significant ectopic lipid deposition in the heart and cardiac hypertrophy in the absence of significant changes in blood pressure. The mRNA levels of chemokines at 24 h and cytokines at 24 and 72 h of reperfusion were higher in DIO than in lean mice. In granulation tissue at 72 h of reperfusion, macrophage density was significantly increased, whereas neutrophil density was reduced, in DIO mice compared with lean mice. At 7 days of reperfusion, collagen deposition in the scar was significantly reduced and left ventricular (LV) dilation and cardiac hypertrophy were increased, indicative of adverse LV remodeling, in infarcted DIO mice. Characterization of a murine diet-induced model of obesity and insulin resistance that satisfies many aspects commonly observed in human obesity allows detailed examination of the adverse cardiovascular effects of diet-induced obesity at the molecular level. insulin resistance; cardiac lipotoxicity; ischemia-reperfusion injury; left ventricular remodeling THE INCIDENCE OF OVERWEIGHT and obesity in the Western world has risen dramatically; in the United States, two-thirds of the adult population is overweight and one-third is obese (27). Extreme obesity is known to impact the structure and function of the heart in terms of hemodynamic load, altered left ventricular (LV) remodeling, and impaired ventricular function leading to overt heart failure (30, 31). In at least four community-based, prospective studies, body mass index (BMI) incrementally predicted heart failure risk above and beyond known risk factors for heart failure. Obesity is known to independently increase the risk for hypertension, diabetes, and dyslipidemia, all of which increase the risk for myocardial infarction and subsequent heart failure. On the other hand, when associated with fewer comorbidities, obesity paradoxically has been found to be protective in the short term after a myocardial infarction (39). Nonetheless, the risks for recurrent myocardial infarction and adverse outcome in the long term...