Gender Differences in Obesity-Associated Cardiac Remodeling

The prevalence of obesity has been increasing globally, with important implications for cardiovascular morbidity and mortality. Obesity is linked to changes in cardiac morphology that collectively play a role in the development of heart failure in this population, as hemodynamic and metabolic alterations lead to cardiac hypertrophy and chamber enlargement. Over time subclinical abnormalities in contractile function occur and could progress to overt clinical heart failure. Understanding the relationship between obesity and alterations in cardiac structure and function has important implications for the development of lifestyle and pharmacologic interventions targeting this modifiable risk factor. There is also a growing awareness of the importance of understanding gender differences in obesity. Gender-specific patterns of adiposity and fat distribution in addition to the distinctive hormonal environments of men and women may lead to sex-specific differences in the degree of cardiometabolic risk associated with obesity. Imaging studies have shown that ventricular remodeling in response to obesity differs among the sexes, and these differences may play a role in the female predominance of heart failure with a preserved ejection fraction.