Obesity-related heart failure with preserved ejection fraction (HFpEF) is an important phenotype prevalent in the community.
In this video, , of Saint Luke's Health System in Lee's Summit, Missouri, breaks down some recent data indicating that obesity -- and specifically the amount of adipose and visceral adipose tissue -- is a really important predictor in terms of the risk of developing HFpEF.
Following is a transcript of his remarks:
If you look at the epidemiology of heart failure, there is a very interesting trend that appears to emerge, which is the proportion of patients with heart failure that have preserved ejection fraction -- meaning normal and near-normal left ventricular systolic function -- is increasing over time. That trend is especially clear when you look at the proportion of patients hospitalized with heart failure that have preserved ejection fraction.
The question is why is that happening? Why is the epidemiology of heart failure evolving in a way that as a proportion of patients with reduced ejection fraction heart failure is decreasing and the proportion of patients with preserved ejection is increasing? There are several possible explanations, one of which could be aging of the population, but another one, I think which sometimes we miss, is that obesity and insulin resistance is actually one of the root causes of heart failure with preserved ejection fraction. There's some very compelling and recent data indicating that obesity, in general, and specifically the amount of adipose and visceral adipose tissue is a really important predictor in terms of the risk of developing HFpEF.
That is a very interesting development because if you actually, again, look at the epidemiology, patients with obesity and can commonly have HFpEF are now representing the majority of patients with HFpEF. The epidemiology clearly has evolved and another very interesting angle of this is that if obesity and insulin resistance are potential root causes of a HFpEF epidemic, is there evidence that actually intervening on these root causes, meaning weight loss specifically, whether that could be used as potential treatment for heart failure and preserved ejection fraction prevention and treatment.
There is some data suggesting that lifestyle interventions that focus on reducing caloric intake, so diet and also exercise, produce significant weight loss actually can significantly improve symptoms in people with HFpEF. Another interesting angle is whether medical-assisted or surgical-assisted weight loss could be effective treatment for heart failure and preserved ejection fraction or maybe even also for prevention of HFpEF, and that's something that hasn't yet been evaluated in clinical trials, but I think it's a really exciting area to strive for additional clinical research.