Obesity cardiomyopathy: Difference between revisions
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* An association between obesity and heart failure has been shown in epidemiological studies | * An association between obesity and heart failure has been shown in epidemiological studies | ||
* Clinical studies | * Clinical studies have shown the association between obesity and left ventricular dysfunction, independent of hypertension, coronary artery disease, and other heart diseases. | ||
* Experimental studies demonstrated structural and functional changes in the myocardium in response to obesity. | * Experimental studies demonstrated structural and functional changes in the myocardium in response to obesity. | ||
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* Myocardial remodeling, | * Myocardial remodeling, | ||
* Small-vessel disease (both microangiopathy and endothelial dysfunction). | * Small-vessel disease (both microangiopathy and endothelial dysfunction). | ||
<ref name="pmid25434909">{{cite journal| author=Ebong IA, Goff DC, Rodriguez CJ, Chen H, Bertoni AG| title=Mechanisms of heart failure in obesity. | journal=Obes Res Clin Pract | year= 2014 | volume= 8 | issue= 6 | pages= e540-8 | pmid=25434909 | doi=10.1016/j.orcp.2013.12.005 | pmc=4250935 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25434909 }} </ref> | |||
==Causes== | ==Causes== | ||
Revision as of 02:12, 6 February 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2]
Synonyms and keywords:
Overview
Obesity cardiomyopathy is defined as congestive heart failure due to structural and hemodynamic changes because of obesity. Increased total blood volume and cardiac output because of the high metabolic activity of excessive fat in long-standing obesity may lead to left ventricular dilation, increased left ventricular wall stress, compensatory left ventricular hypertrophy, and left ventricular diastolic dysfunction. Inadequate hypertrophy might tend to left ventricular systolic dysfunction due to high wall stress. .sleep apnea/ obesity hypoventilation syndrome might tend to pulmonary hypertension and subsequent right ventricular structural changes.
My references (Temporary)
Historical Perspective
Obesity cardiomyopathy was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].
The association between [important risk factor/cause] and obesity cardiomyopathy was made in/during [year/event].
In [year], [scientist] was the first to discover the association between [risk factor] and the development of obesity cardiomyopathy.
In [year], [gene] mutations were first implicated in the pathogenesis of obesity cardiomyopathy.
There have been several outbreaks of obesity cardiomyopathy, including -----.
In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose obesity cardiomyopathy.
Classification
There is no established system for the classification of obesity cardiomyopathy.
OR
obesity cardiomyopathy may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
OR
obesity cardiomyopathy may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. obesity cardiomyopathy may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
OR
Based on the duration of symptoms, obesity cardiomyopathy may be classified as either acute or chronic.
OR
If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].
Pathophysiology
The exact pathogenesis of obesity cardiomyopathy is not fully understood.
OR
It is thought that obesity cardiomyopathy is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
OR
[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
OR
Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
OR
[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
OR
The progression to obesity cardiomyopathy usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.
- An association between obesity and heart failure has been shown in epidemiological studies
- Clinical studies have shown the association between obesity and left ventricular dysfunction, independent of hypertension, coronary artery disease, and other heart diseases.
- Experimental studies demonstrated structural and functional changes in the myocardium in response to obesity.
The most important mechanisms in the development of obesity cardiomyopathy are:
- Metabolic disturbances (insulin resistance, increased free fatty acid levels, and also increased levels of adipokines),
- A metabolic disturbances (insulin resistance, increased free fatty acid levels, and also increased levels of adipokines),
- Activation of the renin-angiotensin-aldosterone and sympathetic nervous systems,
- Myocardial remodeling,
- Small-vessel disease (both microangiopathy and endothelial dysfunction).
Causes
Disease name] may be caused by [cause1], [cause2], or [cause3].
OR
Common causes of [disease] include [cause1], [cause2], and [cause3].
OR
The most common cause of obesity cardiomyopathy is [cause 1]. Less common causes of obesity cardiomyopathy include [cause 2], [cause 3], and [cause 4].
OR
The cause of obesity cardiomyopathy has not been identified. To review risk factors for the development of obesity cardiomyopathy, click here.
Differentiating ((Page name)) from other Diseases
obesity cardiomyopathy must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].
OR
obesity cardiomyopathy must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].
Epidemiology and Demographics
The incidence/prevalence of obesity cardiomyopathy is approximately [number range] per 100,000 individuals worldwide.
OR
In [year], the incidence/prevalence of obesity cardiomyopathy was estimated to be [number range] cases per 100,000 individuals worldwide.
OR
In [year], the incidence of obesity cardiomyopathy is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
Patients of all age groups may develop obesity cardiomyopathy.
OR
The incidence of obesity cardiomyopathy increases with age; the median age at diagnosis is [#] years.
OR
obesity cardiomyopathy commonly affects individuals younger than/older than [number of years] years of age.
OR
[Chronic disease name] is usually first diagnosed among [age group].
OR
[Acute disease name] commonly affects [age group].
There is no racial predilection to obesity cardiomyopathy.
OR
obesity cardiomyopathy usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop obesity cardiomyopathy.
obesity cardiomyopathy affects men and women equally.
OR
[Gender 1] are more commonly affected by obesity cardiomyopathy than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
The majority of obesity cardiomyopathy cases are reported in [geographical region].
OR
obesity cardiomyopathy is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
Risk Factors
There are no established risk factors for obesity cardiomyopathy.
OR
The most potent risk factor in the development of obesity cardiomyopathy is [risk factor 1]. Other risk factors include [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of obesity cardiomyopathy include [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
OR
Common risk factors in the development of obesity cardiomyopathy may be occupational, environmental, genetic, and viral.
Screening
There is insufficient evidence to recommend routine screening for [disease/malignancy].
OR
According to the [guideline name], screening for obesity cardiomyopathy is not recommended.
OR
According to the [guideline name], screening for obesity cardiomyopathy by [test 1] is recommended every [duration] among patients with [condition 1], [condition 2], and [condition 3].
Natural History, Complications, and Prognosis
If left untreated, [#]% of patients with obesity cardiomyopathy may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
OR
Common complications of obesity cardiomyopathy include [complication 1], [complication 2], and [complication 3].
OR
Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with obesity cardiomyopathy is approximately [#]%.
Diagnosis
Diagnostic Study of Choice
The diagnosis of obesity cardiomyopathy is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
OR
The diagnosis of obesity cardiomyopathy is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
OR
The diagnosis of obesity cardiomyopathy is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
OR
There are no established criteria for the diagnosis of obesity cardiomyopathy.
History and Symptoms
The majority of patients with obesity cardiomyopathy are asymptomatic.
OR
The hallmark of obesity cardiomyopathy is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of obesity cardiomyopathy. The most common symptoms of obesity cardiomyopathy include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of obesity cardiomyopathy include [symptom 1], [symptom 2], and [symptom 3].
Physical Examination
Patients with obesity cardiomyopathy usually appear [general appearance]. Physical examination of patients with obesity cardiomyopathy is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of obesity cardiomyopathy.
OR
The presence of [finding(s)] on physical examination is highly suggestive of obesity cardiomyopathy.
Laboratory Findings
An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of obesity cardiomyopathy.
OR
Laboratory findings consistent with the diagnosis of obesity cardiomyopathy include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
OR
[Test] is usually normal among patients with obesity cardiomyopathy.
OR
Some patients with obesity cardiomyopathy may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
OR
There are no diagnostic laboratory findings associated with obesity cardiomyopathy.
Electrocardiogram
There are no ECG findings associated with obesity cardiomyopathy.
OR
An ECG may be helpful in the diagnosis of obesity cardiomyopathy. Findings on an ECG suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
X-ray
There are no x-ray findings associated with obesity cardiomyopathy.
OR
An x-ray may be helpful in the diagnosis of obesity cardiomyopathy. Findings on an x-ray suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
OR
There are no x-ray findings associated with obesity cardiomyopathy. However, an x-ray may be helpful in the diagnosis of complications of obesity cardiomyopathy, which include [complication 1], [complication 2], and [complication 3].
Echocardiography or Ultrasound
There are no echocardiography/ultrasound findings associated with obesity cardiomyopathy.
OR
Echocardiography/ultrasound may be helpful in the diagnosis of obesity cardiomyopathy. Findings on an echocardiography/ultrasound suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
OR
There are no echocardiography/ultrasound findings associated with obesity cardiomyopathy. However, an echocardiography/ultrasound may be helpful in the diagnosis of complications of obesity cardiomyopathy, which include [complication 1], [complication 2], and [complication 3].
CT scan
There are no CT scan findings associated with obesity cardiomyopathy.
OR
[Location] CT scan may be helpful in the diagnosis of obesity cardiomyopathy. Findings on CT scan suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
OR
There are no CT scan findings associated with obesity cardiomyopathy. However, a CT scan may be helpful in the diagnosis of complications of obesity cardiomyopathy, which include [complication 1], [complication 2], and [complication 3].
MRI
There are no MRI findings associated with obesity cardiomyopathy.
OR
[Location] MRI may be helpful in the diagnosis of obesity cardiomyopathy. Findings on MRI suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
OR
There are no MRI findings associated with obesity cardiomyopathy. However, a MRI may be helpful in the diagnosis of complications of obesity cardiomyopathy, which include [complication 1], [complication 2], and [complication 3].
Other Imaging Findings
There are no other imaging findings associated with obesity cardiomyopathy.
OR
[Imaging modality] may be helpful in the diagnosis of obesity cardiomyopathy. Findings on an [imaging modality] suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
There are no other diagnostic studies associated with obesity cardiomyopathy.
OR
[Diagnostic study] may be helpful in the diagnosis of obesity cardiomyopathy. Findings suggestive of/diagnostic of obesity cardiomyopathy include [finding 1], [finding 2], and [finding 3].
OR
Other diagnostic studies for obesity cardiomyopathy include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
There is no treatment for obesity cardiomyopathy; the mainstay of therapy is supportive care.
OR
Supportive therapy for obesity cardiomyopathy includes [therapy 1], [therapy 2], and [therapy 3].
OR
The majority of cases of obesity cardiomyopathy are self-limited and require only supportive care.
OR
obesity cardiomyopathy is a medical emergency and requires prompt treatment.
OR
The mainstay of treatment for obesity cardiomyopathy is [therapy].
OR The optimal therapy for [malignancy name] depends on the stage at diagnosis.
OR
[Therapy] is recommended among all patients who develop obesity cardiomyopathy.
OR
Pharmacologic medical therapy is recommended among patients with [disease subclass 1], [disease subclass 2], and [disease subclass 3].
OR
Pharmacologic medical therapies for obesity cardiomyopathy include (either) [therapy 1], [therapy 2], and/or [therapy 3].
OR
Empiric therapy for obesity cardiomyopathy depends on [disease factor 1] and [disease factor 2].
OR
Patients with [disease subclass 1] are treated with [therapy 1], whereas patients with [disease subclass 2] are treated with [therapy 2].
Surgery
Surgical intervention is not recommended for the management of obesity cardiomyopathy.
OR
Surgery is not the first-line treatment option for patients with obesity cardiomyopathy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for obesity cardiomyopathy is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Primary Prevention
There are no established measures for the primary prevention of obesity cardiomyopathy.
OR
There are no available vaccines against obesity cardiomyopathy.
OR
Effective measures for the primary prevention of obesity cardiomyopathy include [measure1], [measure2], and [measure3].
OR
[Vaccine name] vaccine is recommended for [patient population] to prevent obesity cardiomyopathy. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].
Secondary Prevention
There are no established measures for the secondary prevention of obesity cardiomyopathy.
OR
Effective measures for the secondary prevention of obesity cardiomyopathy include [strategy 1], [strategy 2], and [strategy 3].
References
- ↑ Wong C, Marwick TH (2007). "Obesity cardiomyopathy: pathogenesis and pathophysiology". Nat Clin Pract Cardiovasc Med. 4 (8): 436–43. doi:10.1038/ncpcardio0943. PMID 17653116.
- ↑ Alpert MA (2001). "Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome". Am J Med Sci. 321 (4): 225–36. doi:10.1097/00000441-200104000-00003. PMID 11307864.
- ↑ Ebong IA, Goff DC, Rodriguez CJ, Chen H, Bertoni AG (2014). "Mechanisms of heart failure in obesity". Obes Res Clin Pract. 8 (6): e540–8. doi:10.1016/j.orcp.2013.12.005. PMC 4250935. PMID 25434909.