1st Cardiology Department, Hippokration General Hospital, Athens Medical School, Athens, Greece.
Cardiology Department, Heraklion University Hospital, University of Crete, School of Medicine, Heraklion, Greece.
Heart Fail Rev. 2019 Mar;24(2):219-226. doi: 10.1007/s10741-018-9739-3.
Obesity is a major risk factor for the development of chronic heart failure (CHF) and does not only pose diagnostic challenges, but also has prognostic implications for these patients. Paradoxically, obese patients with CHF have a better prognosis than thinner individuals. In recent years, it has been demonstrated that the adipose tissue, even in patients with HF, is not always detrimental, and that obesity may coexist with a phenotype of benign adiposity without systemic metabolic abnormalities. Experimental data have shown that natriuretic peptides (NPs), and in particular brain natriuretic peptide (BNP), play a major role in the communication of the heart with the adipose tissue. Body fat distribution and adipose tissue function show a large degree of heterogeneity among depots and may explain the complex relationship between NPs and body fat. NPs can affect both the quality and the behaviour of fatty tissue, promoting a healthy adipocyte phenotype, and can favourably affect body fat metabolism. In this article, we review the existing literature on the bidirectional effects of BNP and adipose tissue in HF and highlight the complexity of this relationship.
肥胖是慢性心力衰竭（CHF）发展的一个主要危险因素，不仅对诊断构成挑战，而且对这些患者的预后也有影响。矛盾的是，患有 CHF 的肥胖患者比体型较瘦的患者预后更好。近年来，已经证明，脂肪组织，即使在心力衰竭患者中，也并不总是有害的，肥胖可能与良性脂肪蓄积的表型共存，而没有全身代谢异常。实验数据表明，利钠肽（NPs），特别是脑利钠肽（BNP），在心脏与脂肪组织的交流中起着重要作用。体脂分布和脂肪组织功能在不同部位表现出很大的异质性，这可能解释了 NPs 与体脂之间复杂的关系。NPs 可以影响脂肪组织的质量和行为，促进健康的脂肪细胞表型，并可以有利地影响体脂肪代谢。在本文中，我们回顾了关于 BNP 和心力衰竭中脂肪组织的双向作用的现有文献，并强调了这种关系的复杂性。
