Chase Paul J, Davis Paul G, Bensimhon Daniel R
LeBauer Cardiovascular Research Foundation, Cone Health, 1200 N. Elm St, Greensboro, NC, 27401, USA,
Curr Heart Fail Rep. 2014 Mar;11(1):111-7. doi: 10.1007/s11897-013-0184-2.
Heart failure (HF) is a growing health problem, at least in part due to the concurrent obesity epidemic plaguing developed countries. However, once a patient develops HF, an elevated BMI appears to confer a survival benefit--a phenomenon termed the "obesity paradox." The exact explanation for this paradox has been difficult to ascertain. Numerous plausible mechanisms have been asserted, including the fact that obese patients tend to be younger and more symptomatic, leading them to seek medical attention earlier in the course of their HF. Obese patients may also have larger energy reserves that help to offset the catabolic changes seen with HF. Other hypotheses highlight the limitations of BMI as an obesity classifier. The purpose of this review is to examine the various theories for the obesity paradox in HF and discuss the implications for the clinical management of obese patients with HF.
心力衰竭（HF）是一个日益严重的健康问题，至少部分原因是困扰发达国家的肥胖症流行。然而，一旦患者发生心力衰竭，较高的体重指数（BMI）似乎能带来生存益处——这一现象被称为“肥胖悖论”。这一悖论的确切解释一直难以确定。人们提出了许多看似合理的机制，包括肥胖患者往往更年轻且症状更明显，这使得他们在心力衰竭病程中更早寻求医疗关注。肥胖患者也可能有更多的能量储备，有助于抵消心力衰竭时出现的分解代谢变化。其他假说则强调了BMI作为肥胖分类指标的局限性。本综述的目的是探讨心力衰竭中肥胖悖论的各种理论，并讨论其对肥胖心力衰竭患者临床管理的意义。
