肥胖导致心力衰竭的机制。
Mechanisms of heart failure in obesity.
作者信息
Ebong Imo A, Goff David C, Rodriguez Carlos J, Chen Haiying, Bertoni Alain G
机构信息
Department of Medicine, University of Southern California, Los Angeles, CA, United States.
Colorado School of Public Health, Aurora, CO, United States.
出版信息
Obes Res Clin Pract. 2014 Nov-Dec;8(6):e540-8. doi: 10.1016/j.orcp.2013.12.005. Epub 2014 Jan 6.
Heart failure is a leading cause of morbidity and mortality and its prevalence continues to rise. Because obesity has been linked with heart failure, the increasing prevalence of obesity may presage further rise in heart failure in the future. Obesity-related factors are estimated to cause 11% of heart failure cases in men and 14% in women. Obesity may result in heart failure by inducing haemodynamic and myocardial changes that lead to cardiac dysfunction, or due to an increased predisposition to other heart failure risk factors. Direct cardiac lipotoxicity has been described where lipid accumulation in the heart results in cardiac dysfunction inexplicable of other heart failure risk factors. In this overview, we discussed various pathophysiological mechanisms that could lead to heart failure in obesity, including the molecular mechanisms underlying cardiac lipotoxicity. We defined the obesity paradox and enumerated various premises for the paradoxical associations observed in the relationship between obesity and heart failure.
心力衰竭是发病和死亡的主要原因，其患病率持续上升。由于肥胖与心力衰竭有关，肥胖患病率的上升可能预示着未来心力衰竭的进一步增加。据估计，肥胖相关因素导致男性心力衰竭病例的11%，女性为14%。肥胖可能通过引起导致心脏功能障碍的血流动力学和心肌变化，或由于对其他心力衰竭危险因素的易感性增加而导致心力衰竭。已经描述了直接心脏脂毒性，即心脏中的脂质积累导致无法用其他心力衰竭危险因素解释的心脏功能障碍。在本综述中，我们讨论了肥胖中可能导致心力衰竭的各种病理生理机制，包括心脏脂毒性的分子机制。我们定义了肥胖悖论，并列举了肥胖与心力衰竭关系中观察到的悖论关联的各种前提。
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