The Impact of Endothelial Progenitor Cell Dysfunction in Heart Failure “Obesity Paradox”

Heart failure (HF) is a major factor in premature death and inability in the patient with established cardiovascular (CV) disease worldwide [1]. Although CV diseases mediate half of the cases of all newly diagnosed HF, diabetes mellitus and other metabolic diseases may sufficiently increase a risk of HF development and progression [2]. On the other hand overweight and obesity strongly associating with the exaggerated level of the CV risk among none-HF individuals do not relate to poor clinical outcomes in HF patients [3,4]. This phenomenon determines the “obesity paradox”, which is being a U-shaped association between body mass index (BMI) and long-term prognosis in HF patients [5,6]. Interestingly, this paradox has found in many people of the HF patients without corresponding to the number of conventional CV risk factors [7]. Although several explanations of causes of “obesity paradox” development are discovered, most studies appear to be limited by the daily use of BMI to classify the severity of obesity [8]. Indeed, standard anthropometric measures of body mass adjusted to height square, hip and waist circumstances with a further calculation of hip-to-waist ratio that appears to be useful for grading overweight, underweight and obesity have implemented into routine clinical practice to easily stratify the patients from the general population.