ASPECTELE STATUTULUI PRO- INFLAMATOR LA PACIENȚII CU INSUFICIENȚĂ CARDIACĂ ISCHEMICĂ ÎN CONTEXTUL PARADOXULUI OBEZITĂȚII
DOI:
https://doi.org/10.52692/1857-0011.2024.1-78.20Cuvinte cheie:
paradoxul obezității, inflamație, insuficiență cardiacăRezumat
Obezitatea este un predictor independent al bolilor cardiovasculare, cu un risc crescut în prevenția primară, dar conform mai multor studii a fost demonstrat efectul potențial protector al obezității atunci când coexistă cu boala cardiovasculară, fenomen numit „paradoxul obezității”.În timp ce cercetările anterioare au demonstrat că mediatorii inflamatori au fost asociați cu o supraviețuire mai scurtă, efectul inflamației asupra asocierii dintre obezitate și insuficiența cardiacă nu a fost luat în considerare. Se cunoaște că țesutul adipos are un rol crucial în reglarea inflamației și homeostaziei metabolice, însă unele aspecte ale inflamației cronice au și efect adaptativ sau compensator în anumite condiții la persoanele obeze.În acest context, este important să investigăm mecanismele efectului protector a obezității în relație cu insuficiența cardiacă pentru a înțelege acest paradox și pentru a dezvolta strategii de tratament mai eficiente.
Referințe
Lechner K, Lechner B, Crispin A, Schwarz PEH, Bibra H von. Waist-to-height ratio and metabolic phenotype compared to the Matsuda index for the prediction of insulin resistance. Sci Rep 2021;11:8224.
World Health Organization. Obesity and overweight factsheet. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight).
Medina-Inojosa JR, Batsis JA, Supervia M, Somers VK, Thomas RJ, Jenkins S, Grimes C, Lopez- Jimenez F. Relation of waist-hip ratio to long-term cardiovascular events in patients with coronary artery disease. Am J Cardiol 2018;121:903–909.
Oliveros E, Somers VK, Sochor O, Goel K, Lopez- Jimenez F. The concept of normal weight obesity. Prog Cardiovasc Dis 2014;56:426–433).
Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, Coutinho T, Jensen MD, Roger VL, Singh P, Lopez-Jimenez F. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med 2015; 163:827–835).
Sattar N, Welsh P. The obesity paradox in secondary prevention: a weighty intervention or a wait for more evidence? Eur Heart J 2020;41:2678–2680).
Vyas V, Lambiase P. Obesity and atrial fibrillation: epidemiology, pathophysiology and novel therapeutic opportunities. Arrhythm Electrophysiol Rev 2019;8:28–36).
Lavie CJ, Arena R, Alpert MA, Milani RV, Ventura HO. Management of cardiovascular diseases in patients with obesity. Nat Rev Cardiol. 2017;15(1):45– 56. doi:10.1038/nrcardio.2017.108)]
Carbone S, Lavie CJ, Arena R. Obesity and heart failure: focus on the obesity paradox. Mayo Clin Proc. 2017; 92(2) :266–279. doi:10.1016/j. mayocp.2016.11.001
Elagizi A, Kachur S, Lavie CJ, et al. An overview and update on obesity and the obesity paradox in cardiovascular diseases. Prog Cardiovasc Dis. 2018;61(2):142–150. doi:10.1016/j.pcad.2018.07.003].
Fleischmann E, Teal N, Dudley J, May W, Bower JD, Salahudeen AK, et al. Influence of excess weight on mortality and hospital stay in 1346 hemodialysis patients. Kidney Int 1999;55:1560–1567. https://doi.org/10.1046/j.1523-1755.1999.00389.x).
Ryosuke Sato and Stephan von Haehling. Revisiting the obesity paradox in heart failure: what is the best anthropometric index to gauge obesity? European Heart Journal (2023) 44, 1154–1156. https://doi.org/10.1093/eurheartj/ehad079)
Doehner W, Gerstein HC, Ried J, Jung H, Asbrand C, Hess S, Anker SD. Obesity and weight loss are inversely related to mortality and cardiovascular outcome in prediabetes and type 2 diabetes: data from the ORIGIN trial. Eur Heart J 2020;41: 2668–2677).
Romero-Corral A, Montori VM, Somers VK, Korinek J, Thomas RJ, Allison TG, Mookadam F, Lopez- Jimenez F. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. Lancet 2006;368:666–678).
Pocock SJ, Ariti CA, McMurray JJV, Maggioni A, Køber L, Squire IB, Swedberg K, Dobson J, Poppe KK, Whalley GA, Doughty RN. Predicting survival in heart failure: a risk score based on 39 372 patients from 30 studies. Eur Heart J 2013;34:1404–1413.).
McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, et al. Angiotensin– neprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014;371:993–1004. https://doi.org/10.1056/NEJMoa1409077).
Butt JH, Petrie MC, Jhund PS, Sattar NN, Desai AS, Køber L, et al. Association between anthropometric measures and adverse outcomes in heart failure with reduced ejection fraction: revisiting the obesity paradox. Eur Heart J 2023;44:ehad083. https://doi.org/10.1093/eurheartj/ehad083)
Fantuzzi G. Adipose tissue, adipokines, and inflammation. The Journal of allergy and clinical immunology. 2005;115(5):911–919;
Carbone S, Canada JM, Billingsley HE, Siddiqui MS, Elagizi A, Lavie CJ. Obesity paradox in cardiovascular disease: where do we stand?. Vasc Health Risk Manag. 2019;15:89-100 https://doi.org/10.2147/VHRM.S168946
Saleh ZT, Lennie TA, Darawad M, Alduraidi H, Elshatarat RA, Almansour IM, Moser DK. The health outcomes of inflammation and obesity in patients with heart failure. Heart Lung. 2020 Nov- Dec;49(6):896-901. doi: 10.1016/j.hrtlng.2020.05.010. Epub 2020 Jun 5. PMID: 32507469; PMCID: PMC8101500
WHO. Obesity and Overweight (Factsheet no 311), 11 August 2015
European Heart Journal (2023) 44, 1154–1156 https:// doi.org/10.1093/eurheartj/ehad079
Salvino NFA, Sousa LTd, Abrahao FM, Spineti PPdM, Sales ALF, Neves de Albuquerque F, Bittencourt MI, de Moraes PCB, Esporcatte R and Mourilhe- Rocha R (2023) Is the obesity paradox in outpatients with heart failure reduced ejection fraction real? Front. Cardiovasc. Med. 10:1239722. doi: 10.3389/fcvm.2023.1239722
Tiffany M. Powell-Wiley, MD, MPH, FAHA, Chair Paul Poirier, MD, PhD, FAHA, Vice Chair Lora E. Burke et al.. Circulation. 2021;143:e984–e1010. DOI: 10.1161/CIR.0000000000000973)].
Gruberg L, Weissman NJ, Waksman R, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: the obesity paradox? J Am Coll Cardiol 2002;39:578-84.)
Kalantar-Zadeh K, Block G, Horwich T, et al. Reverse epidemiology of conventional cardiovascular risk factors in patients with chronic heart failure. J Am Coll Cardiol 2004;43:1439-44
Niedziela J, Hudzik B, Niedziela N, et al. The obesity paradox in acute coronary syndrome: a meta-analysis. Eur J Epidemiol 2014;29:801-12
Takagi H, Umemoto T. ALICE (All-Literature Investigation of Cardiovascular Evidence) Group. Overweight, but not obesity, paradox on mortality following coronary artery bypass grafting. J Cardiol 2016;68:215-21
Khanna D, Rehman A. StatPearls. Treasure Island. Treasure Island: StatPearls [Internet]; 2022. Pathophysiology of Obesity).
Stenvinkel P, Gillespie I, Thunks J, Addison J, Kronenberg F, Drueke T, Marcelli D, Schernthaner G, Eckardt KU, Floege J, Froissart M, Anker S: The paradoxical association between body mass index and mortality in hemodialysis patients is modified by inflammation. J Am Soc Nephrol 27: 1479–1486, 2016).
Van Linthout S, Tschope C. Inflammation - Cause or Consequence of Heart Failure or Both? Current heart failure reports. 2017;14(4):251–265)
Hohensinner PJ, Niessner A, Huber K, Weyand CM, Wojta J. Inflammation and cardiac outcome. Curr Opin Infect Dis. 2011;24(3):259–264. ].
Shirazi LF, Bissett J, Romeo F, Mehta JL. Role of Inflammation in Heart Failure. Current atherosclerosis reports. 2017;19(6):27).].
Hainer V, Aldhoon-Hainerová I. Obesity paradox does exist. Diabetes care. 2013;36 Suppl 2(Suppl 2):S276–S281
Fantuzzi G. Adipose tissue, adipokines, and inflammation. The Journal of allergy and clinical immunology. 2005;115(5):911–919;
Ludwig, N., Hurt, R.T. & Miller, K.R. The obesity paradox: validity and clinical implications. Curr Pulmonol Rep 6, 58–63 (2017). https://doi.org/10.1007/s13665-017-0167-у.
Descărcări
Publicat
Număr
Secțiune
##category.category##
Licență
Copyright (c) 2024 Buletinul Academiei de Științe a Moldovei. Științe medicale
Această lucrare este licențiată în temeiul Creative Commons Attribution 4.0 International License.
