Hemodynamic Effects of Weight Loss in Obesity: A Systematic Review and Meta-Analysis

Abstract

Objectives We aimed to explore whether weight loss may improve central hemodynamics in obesity Hypothesis Hemodynamic abnormalities in obese HFpEF patients are correlated with the amount of excess body mass, suggesting a possible causal relationship. Methods We systematically searched relevant databases from inception to May 2018, without language restriction. Studies reporting invasive hemodynamic measures prior to and following therapeutic weight loss interventions in patients with obesity but no clinically-overt HF were extracted. Results A total of 9 studies were identified, providing data for 111 patients. Six studies tested dietary intervention and 3 studies tested bariatric surgery. Over a median duration of 9.7 months [range 0.75 to 23], median weight loss of 43 kg [range 10-58] was associated with significant reductions in heart rate [-9 bpm, 95% CI -12 to -6, p Conclusion Therapeutic weight loss in obese patients without HF is associated with favorable hemodynamic effects that could improve symptoms in patients with obesity and HF. Randomized controlled trials evaluating strategies for weight loss in obesity-related HFpEF are needed.