The incidence of obesity and diabetes is increasing rapidly worldwide. Obesity and
metabolic syndrome are strictly linked and represent the basis of different cardiovascular risk
factors, including hypertension and inflammatory processes predisposing to ischemic heart
disease, which represent the most common causes of heart failure. Recent advances in the understanding
of ischemia/reperfusion mechanisms of injury and mechanisms of cardioprotection
are briefly considered. Resistance to cardioprotection may be correlated with the severity
of obesity. The observation that heart failure obese patients have a better clinical condition
than lean heart failure patients is known as “obesity paradox”. It seems that obese patients
with heart failure are younger, making age the most important confounder in some studies.
Critical issues are represented by the "obesity paradox” and heart failure exacerbation by inflammation.
For heart failure exacerbation by inflammation, an important role is played by
NLRP3 inflammasome, which is emerging as a possible target for heart failure condition.
These critical issues in the field of obesity and cardiovascular diseases need more studies to
ascertain which metabolic alterations are crucial for alleged beneficial and deleterious effects
of obesity.
OBESITY PARADOX IN PATIENTS WITH HEART FAILURE READMISSIONS: AN ANALYSIS FROM AHA “GET WITH THE GUIDELINES” HEART FAILURE