Paratz Elizabeth D, Ashokkumar Srikkumar, van Heusden Alexander, Smith Karen, Zentner Dominica, Morgan Natalie, Parsons Sarah, Thompson Tina, James Paul, Connell Vanessa, Pflaumer Andreas, Semsarian Chris, Ingles Jodie, Stub Dion, Gerche Andre La
Baker Heart and Diabetes Institute, 75 Commercial Rd Prahran, Melbourne, VIC 3181, Australia.
Alfred Hospital, 55 Commercial Rd Prahran, Melbourne, VIC 3181, Australia.
Am J Prev Cardiol. 2022 Jul 26;11:100369. doi: 10.1016/j.ajpc.2022.100369. eCollection 2022 Sep.
To contextualize obesity rates in young sudden cardiac death (SCD) against the age-matched national population, and identify clinical and pathologic features in WHO class II and III obesity.
A prospective state-wide out-of-hospital cardiac arrest registry included all SCDs in Victoria, Australia from 2019-2021. Body mass indices (BMIs) of patients 18-50 years were compared to age-referenced general population. Characteristics of SCD patients with WHO Class II obesity (BMI ≥30kg/m) and non-obesity (BMI<30kg/m) were compared. Clinical characteristics of people with BMI>50kg/m were assessed.
504 patients were included. Obesity was strongly over-represented in young SCD compared to the age-matched general population (55.0% vs 28.7%, p<0.0001). Obese SCD patients more frequently had hypertension, diabetes and obstructive sleep apnoea (p<0.0001, p=0.009 and p=0.001 respectively), ventricular fibrillation as their arrest rhythm (p=0.008) and left ventricular hypertrophy (LVH) (p<0.0001). Obese patients were less likely to have toxicology positive for illicit substances (22.0% vs 32.6%, p=0.008) or history of alcohol abuse (18.8% vs 26.9%, p=0.030). Patients with BMI>50 kg/m represented 8.5% of young SCD. LVH (n=26, 60.5%) was their predominant cause of death and only 10 (9.3%) patients died from coronary disease.
Over half of young Australian SCD patients are obese, with all obesity classes over-represented compared to the general population. Obese patients had more cardiac risk factors. Almost two thirds of patients with BMI>50 kg/m died from LVH, with fewer than 10% dying from coronary disease.
将年轻心脏性猝死（SCD）患者的肥胖率与年龄匹配的全国人口情况进行对比，并确定世界卫生组织（WHO）II级和III级肥胖患者的临床和病理特征。
一项全州范围内的院外心脏骤停前瞻性登记研究纳入了2019年至2021年澳大利亚维多利亚州所有的心脏性猝死病例。将18至50岁患者的体重指数（BMI）与年龄匹配的普通人群进行比较。对比WHO II级肥胖（BMI≥30kg/m²）和非肥胖（BMI<30kg/m²）的心脏性猝死患者的特征。评估BMI>50kg/m²人群的临床特征。
共纳入504例患者。与年龄匹配的普通人群相比，肥胖在年轻心脏性猝死患者中所占比例过高（55.0%对28.7%，p<0.0001）。肥胖的心脏性猝死患者更常患有高血压、糖尿病和阻塞性睡眠呼吸暂停（分别为p<0.0001、p=0.009和p=0.001），心脏骤停节律为心室颤动（p=0.008）以及左心室肥厚（LVH）（p<0.0001）。肥胖患者非法物质毒理学检测呈阳性的可能性较小（22.0%对32.6%，p=0.008）或有酒精滥用史的可能性较小（18.8%对26.9%，p=0.030）。BMI>50kg/m²的患者占年轻心脏性猝死患者的8.5%。左心室肥厚（n=26，60.5%）是其主要死因，仅有10例（9.3%）患者死于冠状动脉疾病。
超过一半的澳大利亚年轻心脏性猝死患者肥胖，与普通人群相比，所有肥胖等级的比例均过高。肥胖患者有更多的心脏危险因素。几乎三分之二的BMI>50kg/m²患者死于左心室肥厚，死于冠状动脉疾病的患者不到10%。
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