Pulmonary and cardiovascular complications of obesity: An autopsy study of 76 obese subjects

Abstract Context.—Obesity is associated with sleep disordered breathing and cardiovascular morbidity, but the relationship between pulmonary hypertension, heart disease, and obesity is unknown. Objective.—To determine the prevalence of pulmonary and cardiovascular disease in obese subjects undergoing autopsy at a large medical center. Design.—A search through autopsy records from an 11-year period identified 76 subjects with a body mass index greater than 30 kg/m2 and 46 age-matched, nonobese controls. Clinical data were collected from medical charts and autopsy records. Formalin-fixed, paraffin-embedded sections of lungs and heart were reviewed for each subject. The presence of pulmonary edema, hemorrhage, diffuse alveolar damage, thrombi, and pulmonary hypertensive changes, including intimal fibrosis, medial hypertrophy, muscularization of arterioles, alveolar capillary hemangiomatosis, hemosiderosis, and iron encrustation were documented. Hearts were examined for the presence of cardiomegaly, ventricul...