Cardiac Effects of Obesity

In Brief Obesity produces various hemodynamic alterations and changes in cardiac morphology that predispose to ventricular dysfunction and heart failure (HF). Obesity may serve as a risk factor for or the primary cause of HF. Obesity is also associated with impairment of cardiorespiratory fitness. An obesity paradox exists with respect to mortality in those with HF wherein overweight and mildly to moderately obese individuals have a better prognosis than underweight or normal weight persons. Cardiorespiratory fitness is an important determinant of the prognosis in obesity. Many of the alterations in cardiac structure and function as well as the clinical manifestations of HF are reversible with substantial weight loss in moderately to severely obese individuals. Severe obesity produces changes in cardiac performance and morphology that may lead to ventricular dysfunction and heart failure. Many of these abnormalities improve with substantial weight loss. An obesity paradox for mortality exists for such patients and is heavily influenced by cardiorespiratory fitness.