Obesity cardiomyopathy has often been defined as cardiomegaly with heart failure in individuals with obesity without other etiologies of heart disease. It is thought to typically occur in patients with severe and long-standing obesity. It can be associated with sudden cardiac death. According to some studies it has been characterized by right ventricular hypertrophy and symmetrical left ventricular hypertrophy.
Pathology
Obesity cardiomyopathy is thought to develop independently of hypertension, coronary heart disease, and other heart diseases.
At least two mechanisms have been proposed 1-3
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volume-related
increase in total blood volume and cardiac output as a result of high metabolic activity of excessive fat
in moderate to severe cases of obesity, this may lead to left ventricular dilation, increased left ventricular wall stress, compensatory (eccentric) left ventricular hypertrophy and left ventricular diastolic dysfunction
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effects on right ventricular structure and function from morphologic and hemodynamic alterations (due to volume)
by pulmonary hypertension related to the sleep apnea/obesity hypoventilation syndrome
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