Author + information
- Received December 5, 2012
- Revision received January 25, 2013
- Accepted January 25, 2013
- Published online April 1, 2013.
- Carl J. Lavie, MD∗,†∗ (, )
- Martin A. Alpert, MD‡,
- Ross Arena, PhD, PT§,
- Mandeep R. Mehra, MBBS‖,
- Richard V. Milani, MD∗ and
- Hector O. Ventura, MD∗
- ↵∗Reprint requests and correspondence:
Dr. Carl J. Lavie, John Ochsner Heart and Vascular Institute, Ochsner Clinical School–The University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, Louisiana 70121-2483.
Obesity has reached epidemic proportions in the United States and worldwide. Considering the adverse effects of obesity on left ventricular (LV) structure, diastolic and systolic function, and other risk factors for heart failure (HF), including hypertension and coronary heart disease, HF incidence and prevalence, not surprisingly, is markedly increased in obese patients. Nevertheless, as with most other cardiovascular diseases, numerous studies have documented an obesity paradox, in which overweight and obese patients, defined by body mass index, percent body fat, or central obesity, demonstrate a better prognosis compared with lean or underweight HF patients. This review will describe the data on obesity in the context of cardiopulmonary exercise testing in HF. Additionally, the implications of obesity on LV assist devices and heart transplantation are reviewed. Finally, despite the obesity paradox, we address the current state of weight reduction in HF.
Dr. Mehra has been a consultant for Johnson & Johnson, Abbott Vascular, Boston Scientific, St. Jude, Medtronic, and the National Heart, Lung, and Blood Institute of the National Institutes of Health; and has been an Officer of the HFSA and ISHLT. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 5, 2012.
- Revision received January 25, 2013.
- Accepted January 25, 2013.
- American College of Cardiology Foundation
- Impact of Obesity on Hemodynamics and Left Ventricular Structure and Function
- Obesity and HF
- Obesity Paradox and HF
- Assessing Prognosis in HF: Focus on CPX
- Obesity and Heart Transplantation
- Obesity and Mechanical Circulatory Support Devices
- Intentional Weight Reduction in HF