Obesity paradox, cachexia, frailty, and heart failure

Carl J Lavie; Alban De Schutter; Martin A Alpert; Mandeep R Mehra; Richard V Milani; Hector O Ventura

doi:10.1016/j.hfc.2013.12.002

Obesity paradox, cachexia, frailty, and heart failure

Heart Fail Clin. 2014 Apr;10(2):319-26. doi: 10.1016/j.hfc.2013.12.002.

Authors

Carl J Lavie¹, Alban De Schutter², Martin A Alpert³, Mandeep R Mehra⁴, Richard V Milani², Hector O Ventura²

Affiliations

¹ Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121-2483, USA; Cardiac Rehabilitation, Exercise Laboratories, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121-2483, USA; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808, USA. Electronic address: clavie@ochsner.org.
² Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, 1514 Jefferson Highway, New Orleans, LA 70121-2483, USA.
³ Division of Cardiovascular Medicine, University of Missouri School of Medicine, Room CE-338, 5 Hospital Drive, Columbia, MO 65202, USA.
⁴ BWH Heart and Vascular Center and Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, A Building, 3rd Floor, Room AB324, Boston, MA 02115, USA.

PMID: 24656108
DOI: 10.1016/j.hfc.2013.12.002

Abstract

Overweight and obesity adversely affect cardiovascular (CV) risk factors and CV structure and function, and lead to a marked increase in the risk of developing heart failure (HF). Despite this, an obesity paradox exists, wherein those who are overweight and obese with HF have a better prognosis than their leaner counterparts, and the underweight, frail, and cachectic have a particularly poor prognosis. In light of this, the potential benefits of exercise training and efforts to improve cardiorespiratory fitness, as well as the potential for weight reduction, especially in severely obese patients with HF, are discussed.

Keywords: Cachexia; Frailty; Heart failure; Obesity.

Publication types

Review

MeSH terms

Cachexia / complications*
Cachexia / physiopathology
Health Status
Heart Failure / diagnosis*
Heart Failure / epidemiology*
Heart Failure / therapy
Humans
Obesity / complications*
Obesity / physiopathology
Prognosis