Cited by 121Cardiovascular Function and Risk FactorsCardiovascular Disease and AdiposityCardiac Fibrosis and Remodeling

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Adaptation and Maladaptation of the Heart in Obesity

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Harmancey, Romain, Wilson, Christopher R., Taegtmeyer, Heinrich·2008·Hypertension

DOI 10.1161/hypertensionaha.108.110031PMC PMC3660087

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Abstract

O besity appears to be a major cause of hypertension and associated cardiovascular pathophysiology, including cardiac dysfunction.However, obesity may lead to abnormal cardiac function through mechanisms that are independent of, or that act in concert with, hypertension.One hypothesis of obesity-induced cardiac dysfunction is that an oversupply of substrates leads first to adaptive changes and eventually to contractile dysfunction of the heart.We reason that increased supply of nonesterified fatty acids, together with metabolic dysregulation in obesity, including an inadequate activation of fat oxidation, results in the accumulation of toxic lipid byproducts and subsequent contractile dysfunction.Although the phenomenon may have already been known to Virchow 1 when he described "fatty metamorphosis" of the heart, the concept of cardiac "lipotoxicity" re-emerged only recently with its description in the heart of the obese Zucker diabetic fatty rat. 2 The concept is, however, still a hypothesis rather than an established physiological principle.In spite of the many investigations performed in rodent models, the mechanism(s) responsible for impaired contractile function of the heart is still obscure, and it is uncertain whether lipid metabolites contribute to "obesity cardiomyopathy" in humans.Our brief review is an attempt to understand the chronic regulatory effects of changes in systemic metabolism on cardiac function.In other words, we discuss current concepts of cardiac adaptation and maladaptation to a deranged metabolic environment.

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See all 121

Authors: Harmancey, R., Wilson, C. R., & Taegtmeyer, H.
Affiliations: Texas Medical Center (US)
ORCID: Harmancey, Romain
Taegtmeyer, Heinrich
Venue: Hypertension
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2008-08
Volume: 52
Issue: 2
Pages: 181-187
ISSN: 0194-911X (ISSN-L)
1524-4563
DOI: 10.1161/hypertensionaha.108.110031
PMC: PMC3660087
OpenAlex: W2137438717
Cited by: 121
References: 100
Citations by year: 2026: 2 · 2025: 4 · 2024: 4 · 2023: 5 · 2022: 11 · 2021: 3 · 2020: 3 · 2019: 3 · 2018: 6 · 2017: 3 · 2016: 9 · 2015: 8 · 2014: 13 · 2013: 4 · 2012: 10
FWCI: 1.66
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Hypertension (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Heart, Lung, and Blood Institute (R01HL061483, R01HL073162)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
Keywords: obesity, obesity cardiomyopathy, cardiac dysfunction, lipotoxicity, free fatty acids, fat oxidation, lipid accumulation, contractile dysfunction, cardiac adaptation, metabolic dysfunction, Zucker diabetic fatty rats
MeSH terms: Adaptation, Physiological, Animals, Disease Models, Animal, Fatty Acids, Nonesterified, Female, Heart Failure, Humans, Male, Myocardial Contraction, Myocardium, Obesity, Morbid, Prognosis, Severity of Illness Index, Cohort Studies, Body Mass Index, Reactive Oxygen Species, Risk Assessment, Mice

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Adaptation and Maladaptation of the Heart in Obesity

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