Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Kaufman Center for Heart Failure Treatment and Recovery, Cleveland Clinic, 9500 Euclid Avenue, Desk J3-4, Cleveland, OH, 44195, USA.
Thammasat Heart Center, Thammasat University Hospital, Khlong Luang, Pathum Thani, Thailand.
Curr Diab Rep. 2020 Nov 24;20(12):75. doi: 10.1007/s11892-020-01367-z.
Obesity increases the risk of new onset heart failure (HF), and particularly HF with preserved ejection fraction (HFpEF). Despite the observations of favorable clinical outcomes in HF patients with obesity in general, sometimes referred to as the "obesity paradox," it is important to recognize that severe obesity is associated with worse clinical outcomes. This review summarizes the effects of obesity treatment on cardiovascular health and HF clinical outcomes.
Treatment for obesity utilizes a variety of modalities to achieve purposeful weight loss including lifestyle intervention, medications, and bariatric surgery. There are a cluster of benefits of obesity treatment in terms of clinical outcomes in HF. The mechanisms of these benefits include both weight loss-dependent and weight loss-independent mechanisms. Obesity treatment is safe and associated with favorable clinical outcomes across the spectrum of the HF population. The potential benefits are facilitated through multiple mechanisms.
肥胖增加新发心力衰竭（HF）的风险，尤其是射血分数保留的心力衰竭（HFpEF）。尽管一般来说肥胖 HF 患者的临床结局较好，有时被称为“肥胖悖论”，但需要注意的是，严重肥胖与更差的临床结局相关。本篇综述总结了肥胖治疗对心血管健康和 HF 临床结局的影响。
肥胖治疗采用多种方式实现有目的的体重减轻，包括生活方式干预、药物治疗和减重手术。肥胖治疗在 HF 临床结局方面有一系列获益。这些获益的机制包括体重减轻依赖和非依赖机制。肥胖治疗在 HF 人群中是安全的，并与有利的临床结局相关。潜在获益是通过多种机制实现的。
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