Obesity in Heart Failure: Mechanistic, Diagnostic and Therapeutic Considerations

The prevalence of obesity among the general population has resulted in significant overlap and complex interactions with heart failure. This review aims to describe recent changes to the definition of obesity and explore direct and indirect mechanistic links between obesity and heart failure. Diagnostic challenges presented by obesity regarding echocardiography and B-type natriuretic peptide are also explored. Treatment options and the evidence base for addressing obesity in heart failure are examined across both heart failure with preserved ejection fraction and heart failure with reduced ejection fraction. Finally, the safety profile of new incretin-based therapies is examined.