Association between cardiorespiratory fitness, obesity, and incidence of atrial fibrillation

Abstract

Background The interaction between cardiorespiratory fitness (CRF) and incidence of atrial fibrillation (AF) and the interaction between obesity and incidence of AF have been explored separately. Therefore, we evaluated the association between CRF, body mass index (BMI), and risk of developing AF in a cohort of middle-aged and older US Veterans. Methods Symptom limited exercise tests (ETT) were conducted among 16,397 Veterans (97% male) from January 9,1987 to December 31,2017. No history of AF was evident at the time of the ETTs. CRF was expressed as quartiles of peak metabolic equivalents (METs) achieved within each age decile. Weight status was classified as normal (BMI < 25 kg/m 2 ), overweight (BMI 25–30 kg/m 2 ), obese (BMI 30–35 kg/m 2 ), or severely obese (BMI > 35 kg/m 2 ). Multivariable Cox proportional hazards regression models were used to compare the association between BMI, CRF categories, and incidence of AF. Results Over a median follow-up of 10.7 years, 2,155 (13.1%) developed AF. Obese and severely obese subjects had 13% and 32% higher risks for incidence of AF, respectively, vs. normal weight subjects. Overweight and obese subjects in the most fit quartile had 50% decline in AF risk compared to the least-fit subjects. Severely obese subjects had marked increases in AF risk (~50–60%) regardless of fitness level. Risk of developing AF increases with higher BMI and lower CRF. Conclusion Improving CRF should be advocated when assessing those at risk for developing AF.

Impact of training modes on fitness and body composition in women with obesity: A systematic review and meta‐analysis

“…Both reduced %BF and increased CRF are linked to improvements in obesity‐related disorders and decreases in adiposity‐linked inflammation (85‐87). Indeed, research indicates that a 1‐MET increase in CRF correlates with a decrease in cardiovascular risk factors often comorbid with obesity (i.e., hypertension, metabolic syndrome) of up to 22% and a reduced risk of arrhythmias and heart failure in adults with obesity by at least 6% and 21%, respectively (87‐90). Equally, whereas increased muscle mass is positively linked with a greater resting metabolic rate (i.e., 1 kg of muscle gained equals an increase of ~21 kcal/kg) (81), which is significant for weight loss, improvements in lean mass have been shown to more considerably impact health outcomes by decreasing the risk of metabolic syndrome in WLO by up to 33% (91).…”

Assessment of aerobic exercise capacity in obesity, which expression of oxygen uptake is the best?

“…Depending on the presence of obesity related disorders, peak exercise capacity will evolve differently in different subjects. 48 , 49 , 50 , 51 Healthy obese subjects undergoing weight loss are more likely to experience a decrease in O 2max and peak work output, because of decreased muscle mass 33 and daily cardiac stress. Following weight loss, lower weight-bearing daily activities lead to less cardiac stress, so before surgery carrying more weight during daily activities may be considered as training which can stimulate muscle work and cardiac stress, 33 but after surgery, BW is lower and this effect on muscle 41 and heart 44 , 52 fades away.…”

Sleep apnea and atrial fibrillation: Update 2020

“…The knowledge about SDB status in AF patients is important to approximate success rates of interventions. SDB is associated with increased AF recurrence rates after antiarrhythmic drug treatment, electrical cardioversion, and catheter ablation in AF [5] , [6] , [7] . Observational studies and meta-analyses showed that appropriate SDB treatment may improve rhythm control in AF patients [8] .…”