Sudden Cardiac Death most common among young males with Obesity Cardiomyopathy

In a retrospective case-control autopsy study, Joseph Westaby and team have found the elusive phenomenon, Obesity Cardiomyopathy (OCM) and its association with sudden cardiac death (SCD). The findings were published in the Journal of American College of Cardiology.

With obesity rates on the rise globally, researchers have become increasingly concerned about the potential cardiovascular consequences of this epidemic. Among these concerns is OCM, a condition characterized by an enlarged heart and impaired cardiac function in individuals with obesity. Although the link between OCM and SCD has been suspected, the pathologic features of this association have remained largely unexplored.

The research team, comprising experts from multiple disciplines, identified 53 cases of OCM associated with SCD from a pool of 6,457 SCD cases. These OCM cases were meticulously matched with 106 obese SCD controls and 106 normal-weight SCD controls, all of whom had morphologically normal hearts.

The findings revealed that OCM predominantly affects young males, with a mean age of 42 ± 12 years, and a notable male predominance (64%). Intriguingly, males succumbed to OCM-related SCD at a younger age than females, indicating potential gender-related differences in disease progression.

One of the key distinguishing features of OCM was the increased heart weight, with an average of 598 ± 93 grams, surpassing the defined threshold for males and females with obesity. Furthermore, both the right and left ventricular walls exhibited thickening in OCM cases compared to the control groups, indicating structural changes in the heart due to OCM.

The study also revealed that right ventricular epicardial fat was notably increased in OCM cases compared to normal-weight controls, hinting at a possible involvement of this fat depot in the pathogenesis of OCM.

Of particular significance was the identification of left ventricular fibrosis in 13% of OCM cases. Fibrosis is associated with adverse cardiac remodeling and dysfunction, providing valuable insights into the mechanisms underlying OCM-related SCD.

Source:

Westaby, J., Dalle-Carbonare, C., Ster, I. C., & Sheppard, M. N. (2023). Obesity Cardiomyopathy in Sudden Cardiac Death. In JACC: Advances (Vol. 2, Issue 5, p. 100414). Elsevier BV. https://doi.org/10.1016/j.jacadv.2023.100414