67 Obesity and Sudden Death. Pathological Insights from a Large Pathology Registry

Aims Obesity is a rising public health problem and widely known risk factor for cardiovascular diseases. The relationship between obesity and sudden cardiac death (SCD) is unclear and based on small cohort studies. The aim of the study was to determine the main features and aetiologies in a large cohort of SCD occurred in obese subjects Methods Between 1994 and 2014, 3684 consecutive cases of SCD were referred to our cardiac pathology centre. In 1954 body mass index (BMI) data were available; obesity was defined by a BMI ≥ 30. All subjects underwent macroscopic and microscopic post-mortem evaluation by an expert cardiac pathologist. Clinical information were obtained from the referring coroners. Results Four hundred ninety-one patients (25%) were obese. The average heart weight (HW) in obese patients was 505 ± 170 g and 186 (38%) had a HW of more than 500 g. Obese patients were older at death (39 ± 14 vs 35 ± 16 years in non-obese, p Conclusions Various conditionsunderlie SCD inobese patients, with a prevalence of SADS, ILVH and CAD. The degree of hypertrophy measured by heart weight appears in excess even after correction for body size, postulating its possible pathogenetic role in the development of fatal arrhythmias. Almost one in four young obese sudden death victims shows some degree of CAD, underscoring the need for primary prevention in this particular subgroup.