Forgotten but not gone the rediscovery of fatty heart, the most common unrecognized disease in America

被引:191
作者
Szczepaniak, Lidia S.
Victor, Ronald G.
Orci, Lelio
Unger, Roger H.
机构
[1] Univ Texas, Southwestern Med Ctr, Touchstone Ctr Diabet Res, Dallas, TX 75390 USA
[2] Univ Texas, Southwestern Med Ctr, Div Hypertens, Dept Internal Med, Dallas, TX 75390 USA
[3] Univ Texas, Southwestern Med Ctr, Dept Radiol, Dallas, TX 75390 USA
[4] Vet Affairs Med Ctr, Dallas, TX USA
[5] Univ Med Ctr, Dept Physiol & Cell Metab, Geneva, Switzerland
关键词
magnetic resonance spectroscopy; lipotoxic cardiomyopathy; fatty heart; obesity;
D O I
10.1161/CIRCRESAHA.107.160457
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Until 60 years ago, fatty heart was an accepted clinical entity. Since then, its very existence has been questioned, despite the fact that 2 of 3 Americans are now obese or overweight and obesity has been shown to be correlated with cardiac functional abnormalities. In 2000, a syndrome of "lipotoxic cardiomyopathy" resembling earlier pathologic descriptions of fatty human hearts was described in rodents, and fatty infiltration of cardiomyocytes was subsequently reported in patients with congestive failure. Now, magnetic resonance spectroscopy has been adapted to permit routine noninvasive screening for fatty heart. The use of this technique in human volunteers indicates that cardiomyocyte fat correlates well with body mass index and is elevated in uncomplicated obesity. It is more severe when glucose tolerance becomes abnormal or diabetes is present. It is associated with impaired diastolic filling, even in seemingly asymptomatic obese volunteers. Because fatty heart can be readily prevented by lifestyle modification and pharmacologic interventions that reduce caloric intake and increase fatty acid oxidation, it seems important to recognize its existence so as to intervene as early as possible.
引用
收藏
页码:759 / 767
页数:9
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