Obesity poses a significant health care burden with rising morbidity and mortality associated with increased risk of heart failure and/or sudden cardiac death linked to cardiac arrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF). While obesity is well documented as an independent risk factor for cardiovascular disease including arrhythmias, the underlying mechanisms are not well understood.
Then there is the confounding epidemiological observation called the obesity paradox, which suggests better survival outcomes for obese patients compared to non-obese patients in multiple clinical conditions. This includes coronary heart disease, acute myocardial infarction, cardiac arrhythmias, heart failure even in adults with congenital heart disease, pulmonary arterial hypertension, and chronic kidney disease. The reasons for these obesity paradoxes in cardiovascular outcomes are not entirely clear.
The big picture question that is focus of my research is this. Does cardiac obesity promote or protect against arrhythmias? Or both?
– If cardiac obesity promotes arrhythmias, what are underlying mechanisms?
– If cardiac obesity protects against arrhythmias, under what conditions? And what are the mechanisms?