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Review
. 2019 Jul;15(3):349-358.
doi: 10.1016/j.hfc.2019.02.004. Epub 2019 Apr 5.

Metabolic Syndrome in Heart Failure: Friend or Foe?

Michele Arcopinto  1 , Alessandra Schiavo  1 , Andrea Salzano  2 , Eduardo Bossone  3 , Roberta D'Assante  4 , Fabio Marsico  5 , Pablo Demelo-Rodriguez  6 , Ragavendra R Baliga  7 , Antonio Cittadini  8 , Alberto M Marra  9
Affiliations
Review

Metabolic Syndrome in Heart Failure: Friend or Foe?

Michele Arcopinto et al. Heart Fail Clin. 2019 Jul.

Abstract

The interplay between metabolic syndrome (MetS) and heart failure (HF) is intricate. Population studies show that MetS confers an increased risk to develop HF and this effect is mediated by insulin resistance (IR). However, obesity, a key component in MetS and common partner of IR, is protective in patients with established HF, although IR confers an increased risk of dying by HF. Such phenomenon, known as "obesity paradox," accounts for the complexity of the HF-MetS relationship. Because IR impacts more on outcomes than MetS itself, the former may be considered the actual target for MetS in HF patients.

Keywords: Heart failure; Insulin resistance; Metabolic syndrome; Prognosis; Risk stratification.

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