Dramatic loss of weight in an obese patient with heart failure: a mighty heart in a big man

Abstract Obesity has reached global epidemic proportions and has been associated with numerous comor- bidities, including major cardiovascular diseases and heart failure. It has many adverse effects on hemodynamics and cardiovascular structure and function; it increases total blood volume and cardiac output, and also activates several neurohumoral systems that play an important role in causing cardiac dysfunction. Typically, obese patients have a higher cardiac output but a lower level of total peripheral resistance at any given level of arterial pressure. Over the past few years, experimental evidence has unraveled some important pathogenetic mechanisms that may underlie a specifi c form of “obesity cardiomyopathy”. However, many unanswered questions remain regarding the pathophysiological interactions between obesity and the heart. L Heart Metab; 2013;61: