Sudden death as a result of heart disease in morbid obesity

doi:10.1016/0002-8703(95)90445-X

American Heart Journal

Volume 130, Issue 2, August 1995, Pages 306-313

https://doi.org/10.1016/0002-8703(95)90445-X Get rights and content

Abstract

Patients with morbid obesity have high rates of sudden, unexpected cardiac death. The mechanism of death in these patients is uncertain. Twenty-eight patients with morbid obesity (22 sudden cardiac deaths, 6 unnatural deaths) were compared to 11 age-matched nonobese patients with traumatic deaths. Heart weight, left ventricular cavity diameter, left and right ventricular wall thickness, ventricular septal thickness, epicardial fat thickness, and extent of coronary artery atherosclerosis were determined; myocyte size, nuclear size, and degree of interstitial fibrosis were calculated morphometrically. Mean heart weights in the patients with morbid obesity were increased but remained constant as a percentage of body weight. Of the gross parameters, only heart weight and left ventricular cavity size were independent predictors of obesity. Of microscopic parameters, only nuclear area was an independent predictor of obesity. Of 22 patients with morbid obesity, dilated cardiomyopathy was the most frequent cause of sudden cardiac death in (10 patients,) followed by severe coronary atherosclerosis (6), concentric left ventricular hypertrophy without left ventricular dilatation (4), pulmonary embolism (1), and hypoplastic coronary arteries (1). The cardiomyopathy of morbid obesity is characterized by cardiomegaly, left ventricular dilatation, and myocyte hypertrophy in the absence of interstitial fibrosis. It is the most common cause of sudden cardiac death in these patients.

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Clinical investigationSudden death as a result of heart disease in morbid obesity

Abstract

Am J Cardiol

Prog Cardiovasc Dis

Am J Cardiol

Am J Clin Nutr

Mayo Clin Proc

Mayo Clin Proc

Am J Cardiol

Am J Med

Am J Cardiol

Am J Cardiol

Chest

Am J Surg

Lancet

Clinical investigation
Sudden death as a result of heart disease in morbid obesity