Obesity and heart failure (HF) with preserved ejection fraction (HFpEF) represent two intermingling epidemics driving perhaps the greatest unmet health problem in cardiovascular medicine in the 21st century. Many patients with HFpEF are either overweight or obese, and recent data have shown that increased body fat and its attendant metabolic sequelae have widespread, protean effects systemically and on the cardiovascular system leading to symptomatic HFpEF. The paucity of effective therapies in HFpEF underscores the importance of understanding the distinct pathophysiological mechanisms of obese HFpEF to develop novel therapies. In this review, we summarize the current understanding of the cardiovascular and non-cardiovascular features of the obese phenotype of HFpEF, how increased adiposity might pathophysiologically contribute to the phenotype, and how these processes might be targeted therapeutically.

中文翻译：

---

射血分数保留的肥胖和心力衰竭：新见解和病理生理学目标


肥胖和射血分数保留的心力衰竭 (HFpEF) 是两种相互交织的流行病，可能导致 21 世纪心血管医学中最大的未解决的健康问题。许多 HFpEF 患者要么超重，要么肥胖，最近的数据表明，体脂增加及其伴随的代谢后遗症对全身和心血管系统产生广泛的、多变的影响，导致症状性 HFpEF。 HFpEF 有效疗法的缺乏凸显了了解肥胖 HFpEF 独特病理生理机制以开发新疗法的重要性。在这篇综述中，我们总结了目前对 HFpEF 肥胖表型的心血管和非心血管特征的理解，肥胖增加如何在病理生理学上影响该表型，以及如何针对这些过程进行治疗。