Key result
Obesity and metabolic disorders synergistically drive adverse myocardial structural remodeling and dysfunction.
Why the study?
The concept of metabolic phenotypes was suggested as a new way to study the impact of obesity and concomitant metabolic disorders on cardiovascular disease risk and mortality.
Understanding the distinct cardiac impacts of different metabolic phenotypes can help tailor diagnostic and therapeutic strategies for patients with obesity and heart failure with preserved ejection fraction.
May refine CV risk assessment via metabolic phenotyping in obesity; leaves open whether phenotype-specific therapies alter outcomes.
Cardiovascular mortality still takes leading places among causes of mortality from different disease in developed countries including Russian Federation. Influence of adipose tissue excess on myocardium is widely discussed in scientific literature. The concept of metabolic phenotypes was suggested as a new way for study of impact of obesity and concomitant metabolic disorders in to the risk of cardiovascular diseases and mortality from them. In this review we discussed the accumulated experience of the Russian and international trials about structural and functional characteristics of myocardium described with various instrumental methods of diagnosis. Special attention is focused on the description of echocardiography as the most available visualizing method, actual diagnostic criteria of disturbances are provided according to Russian and international guidelines. Features and methods of diagnosis of diastolic dysfunction and cardiac remodeling in terms of heart failure with preserved ejection fraction in people with various metabolic phenotypes are discussed. The majority of authors declare the absence of evident decrease of systolic function, as a result the estimation of diastolic dysfunction is very actual. Issues connected to historical transformation of the term obesity paradox and obese cardiopathy, myocardial fat ectopy are covered. The results of experimental and morphological studies present the facts about different impact of adipose tissue and metabolic disorders to development changes in myocardium.
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Постоева et al. (2024) conducted a review in Obesity, metabolic syndrome, and heart failure with preserved ejection fraction. Different metabolic phenotypes (obesity and metabolic syndrome) vs. Metabolically healthy individuals without obesity was evaluated. Obesity and metabolic disorders independently and synergistically contribute to structural and functional myocardial changes, emphasizing the importance of distinguishing metabolic phenotypes in assessing cardiovascular risk.
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