Excess and Dysfunctional Fat as a Primary Driver of Heart Failure With Preserved Ejection Fraction: From Institutional Recognition to Clinical Integration - PubMed
3 hours ago
- #Obesity
- #Heart Failure
- #Adipokines
- Epidemiological and genetic studies strongly link central obesity and visceral adiposity to heart failure with preserved ejection fraction (HFpEF).
- The American Heart Association identifies excess/dysfunctional fat as the primary upstream cause of the cardiovascular-kidney-metabolic syndrome, which includes HFpEF as its advanced stage.
- Dysfunctional adipose tissue secretes proinflammatory adipokines, which have been experimentally confirmed to causally contribute to HFpEF pathogenesis.
- Adipose tissue signaling can amplify HFpEF development, even when the initial trigger is another disorder like pressure overload, via cross-talk with the stressed heart.
- Excess/dysfunctional fat is also recognized as a major driver of common HFpEF comorbidities: hypertension, type 2 diabetes, metabolic liver disease, and chronic kidney disease.
- Future work is needed to develop clinical, imaging, and biomarker tools to identify inflamed, biologically active visceral fat in individual patients.
- Ongoing clinical trials favor developing adipose biological modulators for treating a broad HFpEF population.