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Obesity related cardiomyopathy

Obesity is becoming a worldwide epidemic and a major health problem, since its presence is associated with significant adverse effects on health including metabolic, cardiac and vascular complications. According to latest research, ectopic visceral fat accumulation is an important predictor of diseases, particularly of cardiovascular diseases and insulin resistance, carrying more risk than general fat accumulation. Cardiac ectopic fat includes fat deposition around the heart (epicardial and intrathoracic fat) and intra- myocardial fat cells. All ectopic fat depots are related to conventional risk factors for cardiovascular diseases. Adipocytes act as an endocrine organ, producing number of adipocytokemokines. Leptin and adiponectin are adipokines with significant role in development of cardiovascular diseases, including atherosclerosis, cardiac hypertrophy and myocardial extracellular matrix remodeling. The level of circulating protective adiponectin is decreased (hypoadiponectinemia) while leptin level is increased (hyperleptinemia) in obese patients. Hypoadiponectinemia and hyperleptinemia have proatherosclerotic and proinflammatory effects inducing hypertrophic signal in cardiomyocytes via complex mechanisms. It can be concluded that obesity, cardiac fat, inflammation and adipokines changes contribute to local and systemic, metabolic and mechanical changes in cardiovascular system, with pathohistological and pathophysiological changes of cardiomyocytes and myocardium. Result of all these changes is obesity related cardiomyopathy with disturbances of myocardium relaxation and diastolic dysfunction.

adiponectin ; leptin ; cardiomyopathy ; obesity ; epicardial adipose tissue ; cardiomyoptahy

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