Adiposity of the heart, revisited

Jonathan M. McGavock, Ronald G. Victor, Roger H Unger, Lidia S. Szczepaniak

Research output: Contribution to journalArticle

273 Citations (Scopus)

Abstract

Obesity is a major risk factor for heart disease. In the face of obesity's growing prevalence, it is important for physicians to be aware of emerging research of novel mechanisms through which adiposity adversely affects the heart. Conventional wisdom suggests that either hemodynamic (that is, increased cardiac output and hypertension) or metabolic (that is, dyslipidemic) derangements associated with obesity may predispose individuals to coronary artery disease and heart failure. The purpose of this review is to highlight a novel mechanism for heart disease in obesity whereby excessive lipid accumulation within the myocardium is directly cardiotoxic and causes left ventricular remodeling and dilated cardiomyopathy. Studies in animal models of obesity reveal that intracellular accumulation of triglyceride renders organs dysfunctional, which leads to several well-recognized clinical syndromes related to obesity (including type 2 diabetes). In these rodent models, excessive lipid accumulation in the myocardium causes left ventricular hypertrophy and nonischemic, dilated cardiomyopathy. Novel magnetic resonance spectroscopy techniques are now available to quantify intracellular lipid content in the myocardium and various other human tissues, which has made it possible to translate these studies into a clinical setting. By using this technology, we have recently begun to study the role of myocardial steatosis in the development of obesity-specific cardiomyopathy in humans. Recent studies in healthy individuals and patients with heart failure reveal that myocardial lipid content increases with the degree of adiposity and may contribute to the adverse structural and functional cardiac adaptations seen in obese persons. These studies parallel the observations in obese animals and provide evidence that myocardial lipid content may be a biomarker and putative therapeutic target for cardiac disease in obese patients.

Original languageEnglish (US)
Pages (from-to)517-524
Number of pages8
JournalAnnals of Internal Medicine
Volume144
Issue number7
StatePublished - Apr 4 2006

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Adiposity
Obesity
Lipids
Heart Diseases
Myocardium
Dilated Cardiomyopathy
Heart Failure
Ventricular Remodeling
Left Ventricular Hypertrophy
Cardiomyopathies
Cardiac Output
Type 2 Diabetes Mellitus
Coronary Artery Disease
Rodentia
Triglycerides
Magnetic Resonance Spectroscopy
Animal Models
Biomarkers
Hemodynamics
Hypertension

ASJC Scopus subject areas

  • Medicine(all)

Cite this

McGavock, J. M., Victor, R. G., Unger, R. H., & Szczepaniak, L. S. (2006). Adiposity of the heart, revisited. Annals of Internal Medicine, 144(7), 517-524.

Adiposity of the heart, revisited. / McGavock, Jonathan M.; Victor, Ronald G.; Unger, Roger H; Szczepaniak, Lidia S.

In: Annals of Internal Medicine, Vol. 144, No. 7, 04.04.2006, p. 517-524.

Research output: Contribution to journalArticle

McGavock, JM, Victor, RG, Unger, RH & Szczepaniak, LS 2006, 'Adiposity of the heart, revisited', Annals of Internal Medicine, vol. 144, no. 7, pp. 517-524.
McGavock JM, Victor RG, Unger RH, Szczepaniak LS. Adiposity of the heart, revisited. Annals of Internal Medicine. 2006 Apr 4;144(7):517-524.
McGavock, Jonathan M. ; Victor, Ronald G. ; Unger, Roger H ; Szczepaniak, Lidia S. / Adiposity of the heart, revisited. In: Annals of Internal Medicine. 2006 ; Vol. 144, No. 7. pp. 517-524.
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