Impact Of Obesity And Metabolic Comorbidities On Functional Capacity And Quality Of Life In Heart Failure With Preserved Ejection Fraction

Abstract

Heart failure with preserved left ventricular ejection fraction is a common clinical form of chronic heart failure and is frequently associated with arterial hypertension, ischemic heart disease, obesity, and diabetes mellitus. These comorbidities significantly affect symptom severity, myocardial remodeling, and quality of life. Objective. To evaluate clinical manifestations, anthropometric obesity indicators, quality of life, physical performance, and echocardiographic characteristics in patients with heart failure with preserved ejection fraction. Materials and Methods. The study included 72 patients aged 47–77 years (mean age 59.6 ± 7.8 years). Clinical status and New York Heart Association functional class were assessed. Quality of life was evaluated using the Minnesota Living with Heart Failure Questionnaire. Physical performance was assessed by the six-minute walk test. Anthropometric parameters included body mass index calculated by the Quetelet formula and waist circumference. Transthoracic echocardiography and serum N-terminal pro-brain natriuretic peptide measurement were performed. Results. Excess body weight or obesity was detected in 59 patients (81.9%), and abdominal obesity was present in 49 patients (68.1%). Dyspnea on exertion was reported by 69 patients (95.8%). Increasing functional class was associated with higher body mass index, larger waist circumference, greater left ventricular myocardial mass, shorter walking distance in the six-minute test, and worse quality-of-life scores.

Conclusion. Heart failure with preserved ejection fraction is characterized by universal diastolic dysfunction, high prevalence of obesity, reduced exercise tolerance, and impaired quality of life. Metabolic comorbidities significantly worsen the clinical course of the disease.