FIGURE 3.

Overall impact of excessive adipose accumulation on cardiac hemodynamic and ventricular function: Under severe obese condition, alterations in ventricular function and abnormalities in cardiac hemodynamic lead to heart failure. Severe obesity induces left ventricular (LV) hypertrophy, which may be eccentric (predominant in normotensive severe obesity) or concentric (predominant in severe obesity and obesity with established systemic hypertension). It is uncertain to what extent metabolic alterations including leptin/insulin resistance, lipid toxicity, and altered renin-angiotensin-aldosterone system (RAAS) may lead to obesity cardiomyopathy. RV, right ventricular; LV, left ventricular; TNF, tumor necrosis factor; IL-6, interleukin-6; iNKT cells, invariant natural killer T cells; LA, left atria.