Heart failure and metabolic disease

61

The metabolic contribution to heart failure

Gary D. Lopaschuk
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, AB, Canada
Heart Metab. (2013) 61:2–3

  • Obesity and diabetes are widely recognized as major risk factors for the development of heart failure [1, 2]. Heart failure in obese individuals and those with diabetes is characterized by the early development of left ventricular diastolic dysfunction, increased left ventricular mass, increased left ventricular wall thickness, and the eventual development of left ventricular systolic dysfunction. This increased risk of developing heart failure in obese individuals and those with diabetes persists even after adjusting for independent factors including coronary artery disease and hypertension. As a result, a considerable research effort has focused on the mechanisms responsible for the increased prevalence of heart failure in obesity and diabetes. Potential contributing factors identified include increased oxidative stress, development of cardiac autonomic neuropathies, accelerated apoptosis, accelerated inflammatory responses, accelerated fibrosis, altered cardiac Ca2+ and Na+ handling, production of advanced glycation end products and receptors for advanced glycation end product activation, increased polyol pathway activity, activation of NADPH oxidase, and increased O-linked β-Nacetylglucosamine. Alterations in cardiac energetics also occur in the failing heart, especially in the setting of obesity and diabetes, and are thought to contribute to the severity of heart failure. This issue of Heart and Metabolism focuses on the energy metabolic changes that occur in the setting of obesity and diabetes, and how these changes may contribute to the severity of heart failure. read more…

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