Obesity Cardiomyopathy (OCM) describes structural and functional changes to the myocardium in the context of elevated BMI (BMI>30kg/m2), and in the absence of the traditional risk factors for heart failure.
Obesity has been observed to be an independent risk factor for Sudden Cardiac Death (SCD).
There is no genetic testing pathway for SCD in OCM outside the context of the current National Genomic Testing Directory guidelines.
No monogenic basis for OCM has been identified. Further exploration of the obese SCD population is needed to help mould genomic testing guidelines.
Obesity, defined as an elevated body mass index (BMI) > 30kg/m2, has reached epidemic proportions worldwide. As of 2022, 1 in 8 people are living with the condition, with the number of adults affected having doubled since 1990. (1) Obesity Cardiomyopathy (OCM) describes cardiomegaly and/or myocardial dysfunction in the presence of an elevated BMI >30kg/m2. (2) Whilst cardiomegaly on autopsy is common in obese individuals, OCM is only presumed in the absence of common offending conditions such as hypertension, diabetes and coronary artery disease (CAD). (3) OCM can be associated with sudden cardiac death (SCD) and hence may be a trigger for genetic testing. Although NHS England has delineated clear testing criteria for sudden unexplained death, the role of genetic testing in those with OCM who do not meet the traditional SCD criteria is not clear. (4)
