Body and heart: Effects of weight gain and loss on left ventricular size and function

The metabolic and hemodynamic consequences of obesity, and even overweight, adversely affect the health of millions of individuals across the world and have become a global epidemic.1 Body weight comprises both fat (FM) and fat free (lean) mass (FFM). In older adults, while lean tissue mass is associated with reduced cardiovascular mortality, very low or high FM can be associated with adverse outcomes.2 Much of the adverse effects of obesity may be mediated through adverse effects on cardiac structure and function. Decades of research3–5 have established that increased left ventricular (LV) mass (weight), even below levels exceeding reference values which demarcate hypertrophy, and alterations of the geometry of the LV are associated with adverse cardiovascular outcomes, including diastolic dysfunction and heart failure—often with preserved ejection fraction.