Ján Murín, Jozef Bulas, Michaela Macháčová, Romana Compagnon, Martin Wawruch
About half of patients with heart failure have heart failure with preserved ejection fraction (EF ≥ 50%) and the problem
is here disturbed relaxation of left ventricle. These are more elderly patients, more women and they have also
more co-morbidities. Also obesity is here more often. Patients with obesity, in comparison without, have an expansion
of plasmatic volume and a mild enlargement of left ventricle, and ventricular relaxation is impaired by a presence
o myocardial inflammation, microvascular rarefaction and an increase of fibrosis - therefore these patients
have an increase of ventricular filling pressures and symptoms of heart failure are coming – this is a special form
of heart failure in obesity. Pathomechanisms of this heart failure form are: increased aldosterone serum levels, activation
of renal sympathetic system, reduction of activity of natriuretic peptides and activation of vascular systemic
inflammation. How can we treat this form of heart failure: mineralocorticoid blocker, neprilysin inhibitor, non-selective
betablocker, of course also diuretic (if needed) and treatment of all como rbidities.