Obesity and metabolic features associated with long-term developing diastolic dysfunction in an initially healthy population-based cohort

Abstract

Subjects with elevated WC and TG may have a higher long-term DD risk. Prevention targeting visceral obesity may help reduce the incidence of DD.

Relation between parameters of body composition and echocardiography in patients with nonvalvular atrial fibrillation

“…Yoon et al [21] reported a significant trend in increasing values of LVM/BSA and LAD across VAT tertiles. In a study by Chau et al [22], individuals with elevated waist circumference had a twofold higher risk of diastolic dysfunction of LV than those without central adiposity. In an investigation by Tugcu et al [23], higher WC was significantly associated with higher LAV.…”

Body mass index and all-cause mortality in heart failure patients with normal and reduced ventricular ejection fraction: a dose–response meta-analysis

“…Obesity may be a risk factor for developing heart failure at an earlier age; younger patients generally have a better prognosis. [32][33][34][35] Thus, so called "reverse-causation" could account for the relationship between obesity and prognosis. Obesity might induce symptoms, such as breathlessness on exertion or lying down, leading to earlier diagnosis of heart failure or even misdiagnosis.…”

“…Weight loss is an ominous sign in patients with heart failure even before patients become notably cachectic. [35][36][37] A recent report 38 suggested that patients with heart failure and a greater waist-hip ratio had a worse prognosis. This may reflect the pro-inflammatory response to accumulation of visceral/omental fat.…”

Heart failure drug treatment

“…59,60 Initially healthy subjects with elevated waist circumference have a higher long-term diastolic dysfunction risk. 61 Several laboratories have suggested obesity (and comorbidities such as chronic kidney disease) lead to a systemic pro-inflammatory state, and generation of reactive oxygen species limits nitric oxide availability to myocytes, resulting in reduced cGMP production and ultimately decreasing protein kinase G activity which may result in hypertrophy 13 and myocyte stiffness. 62 More specifically, obesity may lead to the accumulation and inflammation of epicardial adipose tissue, which may impair the electrophysiological properties and distensibility of the myocardium.…”