The cardiomyopathy of obesity

HE FIRST recognition of a possible association between obesity and ventricular dysfunction appears to be that by Smith and Willius in 1933. ~ These authors, in an analysis of postmortem cardiac findings in 135 overweight patients, reported four markedly obese individuals (body weights ranging from 102 to 250 kg) who died of congestive heart failure (CHF) without evidence of hypertension, coronary, valvular, congenital or other heart disease. The existence of a myopathic state accompanying gross obesity has been subsequently documented by necropsy studies in many similar cases, In this treatise, the author will describe and analyze the observations which now make it possible to characterize, in pathologic, physiologic, and clinical terms, a state of chronic circulatory dysfunction in very obese subjects leading to the development of heart failure, ie, the syndrome of obesity heart disease.