Pulmonary and cardiovascular complications of obesity: an autopsy study of 76 obese subjects.
BACKGROUND
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.


METHODS
A search through autopsy records from an 11-year period identified 76 subjects with a body mass index greater than 30 kg/m(2) 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, ventricular hypertrophy, coronary artery atherosclerosis, acute infarction, fibrosis, and inflammation. Differences between the obese and control groups were compared using a statistical software program.


RESULTS
The obese group demonstrated a greater occurrence of diabetes mellitus, systemic hypertension, pulmonary edema, hemorrhage, and pulmonary hypertensive changes compared with the control group. Alveolar capillary hemangiomatosis was exclusively observed in the obese subjects. Cardiomegaly and left ventricular hypertrophy were present in all obese subjects; approximately one third of the obese subjects had no coronary atherosclerosis.


CONCLUSIONS
Pulmonary hypertensive changes, including venous hypertension and capillary hemangiomatosis, were observed in 72% of obese subjects. Cardiomegaly with biventricular hypertrophy was present in all obese subjects and was suggestive of obesity cardiomyopathy.
Haque
Abida K
AK
Department of Pathology, Methodist Hospital, Houston, TX 77030, USA. ahaque@tmhs.org
Gadre
Swarupa
S
Taylor
Jerrod
J
Haque
Sajid A
SA
Freeman
Daniel
D
Duarte
Alex
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence