ABSTRACT
Therapy of acute exacerbations of congestive heart failure associated with obesity
cardiomyopathy consists of dietary salt restriction, inspired oxygen, diuretics, and
angiotensin-converting enzyme inhibitors or, if left ventricular systolic dysfunction
is present, hydralazine/isosorbide dinitrate. Digitalis may be indicated in selected
cases. These measures may also be useful chronically in association with weight loss.
Substantial weight loss is capable of reversing all of the hemodynamic abnormalities
associated with obesity except elevation of left ventricular filling pressure. Substantial
weight loss may also reduce left ventricular mass and improve left ventricular diastolic
filling in those with left ventricular hypertrophy before weight loss. Left ventricular
systolic function also improves after weight loss in those with impaired pre-weight-loss
systolic function. These beneficial effects of weight loss occur partly because of
favorable alterations in left ventricular loading conditions. Substantial weight loss
in patients with congestive heart failure associated with obesity cardiomyopathy produces
a reversal of many of the clinical manifestations of cardiac decompensation and improves
New York Heart Association functional class in most patients.
KEY INDEXING TERMS
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© 2001 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
