Dear Colleagues,
The last 50 years have produced tremendous changes in lifestyle in the more economically advanced countries. Among these changes some are of a positive nature, such as increased life expectancy and access to high quality medical care and better nutrition for many people, while others will have a negative impact on the future health of the global population. Prominent among the latter are the increase in obesity worldwide and the consequences of the increased levels of glucose and cholesterol in the population, including the young. The two problems meet in the so-called metabolic syndrome, where obesity and hypertension are associated with hyperglycemia or insulin resistance and with hypercholesterolemia and hypertryglyceridemia. 
The diffusion of the problem is so complete that it has been described as one of the modern epidemics, not so different in its consequences from the epidemics of plague or starvation or cholera in past centuries.
The Publisher and the Editor of the new series Hot Topics in Cardiology decided, therefore, to devote a publication to the metabolic syndrome and asked one of the experts in this field, Paul Poirier from the Laval University of Québec, to prepare a manuscript on the subject. 
Professor Poirier has done very fine work. Starting with the circulatory characteristics of adipose tissue and the definition of so-called at-risk obesity, he analyzes, with numerous data and observations, the profile of the impairment of left ventricular function induced by obesity, from simple adipositas cordis to myocardial infiltration, and the results of the research conducted experimentally and clinically to trace the impairment of the heart's functioning. What then follows is a summary of the cardiological techniques for studying the heart in obesity in humans and the clinical syndromes associated with overweight and the particular studies that the presence of obesity requires in the usual heart disorders present also in the nonobese population. Particular emphasis is focused on the arrhythmias, on coronary artery disease and stroke, and on the way obesity aggravates these disorders or induces their early appearance. The peculiar aspects of systolic and diastolic dysfunction are presented with clinical and experimental data. 
The role of diet not only in the reduction of overweight, a major therapeutic problem, but in the diminution of cardiovascular risk as well is analyzed, along with a presentation of the consequences of weight reduction for the various heart diseases. Special emphasis is given to the drugs that help in the reduction of excess weight in obese patients with cardiovascular problems. 
Several tables and figures make the presentation of the data much clearer.
Finally, an exceptional number of references (407) enables the cardiologist, the physician interested in these problems, and the scholar to enlarge the horizon of their knowledge. In all, I believe that this paper contributes to a more complete understanding of one of the most intricate problems of our age.