Issue 10/2025
Hristamyan¹, M., Kitov²,³, S.
1 Department of Epidemiology and Disaster Medicine, Faculty of Public Health, Medical University – Plovdiv
2 Cardiology Clinic, University Hospital “St. George” – Plovdiv
3 First Department of Internal Medicine, Cardiology Section, Medical Faculty, Medical University – Plovdiv
Obesity is a chronic, complex disease characterized by excessive accumulation of body fat and significantly increases the risk of cardiovascular diseases. The World Health Organization reports a substantial rise in obesity prevalence over recent decades, with approximately 1 in 8 people worldwide living with obesity as of 2022. The condition is increasingly prevalent in developing countries as well, highlighting the global scale of the problem. Medical complications of obesity are diverse, with cardiovascular diseases being the leading cause of increased morbidity and mortality. Obesity cardiomyopathy (OCM) represents a distinct clinical and pathological entity characterized by pathological structural and functional changes in the myocardium directly associated with obesity. Epidemiological data indicate that OCM primarily affects individuals with severe obesity (BMI >35 kg/m²), being more common in men, while women exhibit different patterns of cardiac remodeling and an increased risk, particularly among young women with high BMI. OCM is linked to an elevated risk of sudden cardiac death, making it a serious clinical challenge. The pathophysiological mechanisms of OCM include hemodynamic overload, adipose tissue dysfunction, systemic inflammation, lipotoxicity, and metabolic disturbances, leading to myocardial remodeling and both diastolic and systolic dysfunction. Despite advances in recognizing OCM, early diagnosis and differentiation from other cardiomyopathies remain challenging due to frequent comorbidities such as hypertension and diabetes. Further research is needed to elucidate molecular pathways and develop targeted therapies. Efforts in obesity prevention and management are crucial to reducing the burden of OCM and its associated cardiovascular complications.
Key words: Obesity cardiomyopathy, Obesity, Epidemiology, Pathophysiology, Heart failure
Address for correspondence:
Meri Hristamyan
Medical University, Plovdiv
15A, Vasil Aprilov, Str.
4002, Plovdiv
e-mail: meri.hristamyan@mu-plovdiv.bg