心力衰竭患者的肥胖管理：能否改变现状？
Managing Obesity in Heart Failure: A Chance to Tip the Scales?
机构信息
Division of Cardiology, Department of Internal Medicine, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Peter O'Donnell Jr School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
出版信息
JACC Heart Fail. 2024 Jan;12(1):28-34. doi: 10.1016/j.jchf.2023.09.005. Epub 2023 Oct 25.
Obesity is associated with incident heart failure (HF), independent of other cardiovascular risk factors. Despite rising rates of both obesity and incident HF, the associations remain poorly understood between: 1) obesity and HF outcomes; and 2) weight loss and HF outcomes. Evidence shows that patients with HF and obesity have high symptom burdens, lower exercise capacity, and higher rates of hospitalization for HF when compared with patients with HF without obesity. However, the impact of weight loss on these outcomes for patients with HF and obesity remains unclear. Recent advances in medical therapies for weight loss have offered a new opportunity for significant and sustained weight loss. Ongoing and recently concluded cardiovascular outcomes trials will offer new insights into the role of weight loss through these therapies in preventing HF and mitigating HF outcomes and symptom burdens among patients with established HF, particularly HF with preserved ejection fraction.
肥胖与心力衰竭（HF）事件相关，独立于其他心血管危险因素。尽管肥胖和 HF 事件的发生率都在上升，但肥胖和 HF 结局之间的关联，以及体重减轻和 HF 结局之间的关联仍知之甚少。有证据表明，与非肥胖 HF 患者相比，肥胖 HF 患者的症状负担更高，运动能力更低，HF 住院率更高。然而，对于肥胖 HF 患者来说，体重减轻对这些结局的影响仍不清楚。减肥的医学治疗方法的最新进展为显著和持续的体重减轻提供了新的机会。正在进行和最近结束的心血管结局试验将提供新的见解，了解这些治疗方法在预防 HF 和减轻已确诊 HF 患者（尤其是射血分数保留的 HF）的 HF 结局和症状负担方面的作用。
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