Forgotten but not gone: The rediscovery of fatty heart, the most common unrecognized disease in America

Lidia S. Szczepaniak, Ronald G. Victor, Lelio Orci, Roger H Unger

Research output: Contribution to journalReview articlepeer-review

210 Scopus citations


Until 60 years ago, fatty heart was an accepted clinical entity. Since then, its very existence has been questioned, despite the fact that 2 of 3 Americans are now obese or overweight and obesity has been shown to be correlated with cardiac functional abnormalities. In 2000, a syndrome of "lipotoxic cardiomyopathy" resembling earlier pathologic descriptions of fatty human hearts was described in rodents, and fatty infiltration of cardiomyocytes was subsequently reported in patients with congestive failure. Now, magnetic resonance spectroscopy has been adapted to permit routine noninvasive screening for fatty heart. The use of this technique in human volunteers indicates that cardiomyocyte fat correlates well with body mass index and is elevated in uncomplicated obesity. It is more severe when glucose tolerance becomes abnormal or diabetes is present. It is associated with impaired diastolic filling, even in seemingly asymptomatic obese volunteers. Because fatty heart can be readily prevented by lifestyle modification and pharmacologic interventions that reduce caloric intake and increase fatty acid oxidation, it seems important to recognize its existence so as to intervene as early as possible.

Original languageEnglish (US)
Pages (from-to)759-767
Number of pages9
JournalCirculation research
Issue number8
StatePublished - Oct 2007


  • Fatty heart
  • Lipotoxic cardiomyopathy
  • Magnetic resonance spectroscopy
  • Obesity

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine


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