Cardiac autonomic dysfunction in obese subjects

Rossi, Marco; Marti, Giuliano; Ricordi, Luigi; G, Fornasari; Finardi, G; Fratino, Pietro; Bernardi, Luciano

doi:10.1042/cs0760567

Cited by 102 publications

(78 citation statements)

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“…16 Adrenergic-dependent forms of QT prolongation are accompanied by an imbalance in cardiac sympathetic tone. 14 Lastly, autonomic disturbances are reported in the obese state 17,18 and with weight loss under controlled experimental conditions. 19 Thus, although mechanisms of cardiac repolarization change were not explored in the present study, autonomic mechanisms may in-part explain the observed QT and QTc interval reductions.…”

Section: Potential Mechanismmentioning

confidence: 99%

Electrocardiographic QTc interval: short-term weight loss effects

Pietrobelli

Rothacker²,

Gallagher

et al. 1997

Int J Obes

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OBJECTIVE: Prolongation of the QTc interval is a risk factor for ventricular arrhythmias and sudden death. There is a correlation between body mass index (BMI) and QTc, with longer intervals observed in obese subjects. Dieting and weight loss on selected diets are also associated with prolongation of the QTc interval, although the mechanisms and risk factors of this syndrome are not clearly established. The aim of the current investigation was to determine if short-term weight loss over seven days while living on a metabolic ward in¯uences cardiac repolarization as indicated by QT interval duration. DESIGN AND SUBJECTS: The elctrocardiogram QT, RR, and QTc (QT/RR 0.5 ) intervals were assessed in 30 healthy obese (BMI b 27 kg/m 2 ) men and women ingesting a balanced 1120 kcal/d formula diet (23% kcal as fat and 52 g protein/d). RESULTS: Weight loss (3.9 AE 1.7 kg) over seven days had no measurable effect on the RR interval and there was a signi®cant (P 0.02) shortening of the QT interval (mean AE s.d., 0.395 AE 0.028±0.386 AE 0.027 s) and borderline signi®-cant (P 0.11) shortening of the QTc (0.411 AE 0.028±0.404 AE 0.025 s) interval. The QTc interval normalized in three subjects with prolonged baseline QTc ( b 0.44 s). A statistically signi®cant (P 0.007) reduction in systolic blood pressure early in the course of weight loss (day 2) accompanied the electrocardiographic changes. CONCLUSION: These results fail to support the development of cardiac repolarization abnormalities in obese patients who ingest a nutritionally balanced low calorie diet over seven days. A signi®cant reduction in QT interval duration and amelioration of abnormally prolonged baseline QTc intervals suggest improved cardiac repolarization with early weight loss.

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Section: Potential Mechanismmentioning

confidence: 99%

Electrocardiographic QTc interval: short-term weight loss effects

Pietrobelli

Rothacker²,

Gallagher

et al. 1997

Int J Obes

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“…7,8 However, another hallmark factor is the decreased cardiac parasympathetic activity frequently reported in obese patients. [9][10][11] This could, like sympathetic overactivation, explain the tachycardia and the increased risk of cardiovascular mortality through hypertension and sudden cardiac death 9,12 in obese patients. Using a canine model of dietary-induced obesity (dogs fed a high-fat diet), which mimics many of the characteristics of human obesity, [13][14][15] we observed atrial muscarinic receptor downregulation 16 and a decreased high frequency power (HF) of heart rate variability (HRV), which reflects cardiac parasympathetic activity.…”

Section: Introductionmentioning

confidence: 99%

Insulin downregulates M2-muscarinic receptors in adult rat atrial cardiomyocytes: a link between obesity and cardiovascular complications

et al. 2004

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OBJECTIVE:To determine whether decreased cardiac parasympathetic activity observed in obesity is due to insulin-induced alterations in cardiac M 2 -muscarinic receptors and/or adenylyl cyclase activity. DESIGN AND METHODS: After incubation with increasing concentrations of insulin, adult rat atrial cardiomyocytes were assayed for M 2 -muscarinic receptor binding density and affinity, and for M 2 R mRNA expression using RT-PCR analysis. Forskolinstimulated adenylyl cyclase activity and its inhibition by carbachol were also assayed, as was endothelial nitric oxide synthase mRNA expression. The effects of insulin on M 2 -muscarinic receptor density and mRNA expression levels were analyzed using the insulin signaling inhibitors rapamycin, wortmanin and PD 098059. RESULTS: Insulin induces a concentration-and time-dependent decrease in expression of the M 2 R mRNA, and in [ 3 H]Nmethylscopolamine binding by the receptor. These effects on the M 2 R mRNA levels and on [ 3 H]N-methylscopolamine binding were prevented by PD 98059, but not by wortmanin or rapamycin. Basal and forskolin-induced cAMP production did not differ, but the inhibition of forskolin-simulated enzyme activity by carbachol was blunted by insulin. No change in the mRNA levels for endothelial nitric oxide synthase was observed. CONCLUSION: In rat atrial cardiomyocytes, insulin markedly alters both the M 2 -muscarinc receptor density, and its mRNA expression through transcriptional regulation and adenylyl cyclase activity. These data suggest that the obesity-associated decrease in cardiac parasympathetic tone may be related to hyperinsulinemia, which could directly contribute to cardiovascular morbidity in obese patients.

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“…Entretanto, acreditamos que isso não tenhar interferido em nossos resultados, pois ambos os grupos realizaram o teste em uma mesma intensidade de esforço (FCmédia e FCpico) e a relação da liberação das citocinas durante o processo inflamatório e a influência dessas na modulação autonômica está mais associada á obesidade e não ao sobrepeso 30,31 . A diferença estatisticamente significatica da PAD parece não interfirir na homogeneidade do grupo uma vez que está relacionada ao calibre do vaso e á resistência periférica total.…”

Section: Discussionunclassified

Comparação Da Modulação Autonômica Cardíaca Durante Esforço De Fumantes E Não Fumantes

Alves

Oliveira

Alves

et al. 2015

Rev Bras Med Esporte

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RESUMOIntrodução: O tabagismo é uma das principais causas de morbimortalidade em todo o mundo. Indivíduos fumantes têm risco aumentado de desenvolver disfunção autonômica, a qual pode ser avaliada tanto pela variabilidade da frequência cardíaca (VFC) como pela frequência cardíaca de recuperação (FCRec). A maioria dos estudos envolvendo esta análise é realizada em adultos de idade avançada e na condição de repouso. Objetivos: Comparar a atividade autonômica cardíaca em repouso e esforço, em homens jovens, fumantes e não fumantes. Métodos: Trinta e dois jovens voluntários, (idade 22,0 ± 2,8 anos) foram distribuídos em dois grupos: o grupo fumante (GF; n=15) e o não fumante (GNF; n=17). Realizou-se o teste de Cooper, com análise da VFC pelo cardiofrequencímetro Polar ® s810i, em repouso e durante o esforço e FCRec. Resultados: No GF, 73% foram classificados com nível de dependência nicotínica "muito baixa" segundo questionário de Fargeström. A classificação de ativos e muito ativos pelo questionário IPAQ correspondeu a mais de 50% da amostra em ambos os grupos. Não se observou diferenças significativas entre os grupos na VFC, tanto no repouso quanto no esforço. Entretanto, em cada grupo, notou-se diferença na maioria dos índices de VFC do repouso para o esforço. No teste de Cooper não foram observadas diferenças significativas na FCmédia, FCpico e de FCRec entre os grupos, mas notou-se uma melhor capacidade funcional no GNF pela distância caminhada (2050,2 ± 300,0 vs. 1780,3 ± 390,4 m, p=0,036). Conclusão: O GF apresentou menor capacidade funcional e ativação parassimpática durante o esforço, além de menores índices de VFC durante repouso, o que pode sugerir um comprometimento precoce na modulação autonômica cardíaca.Palavras-chave: exercício, hábito de fumar, disautonomias primárias. , were divided into two groups: the smoking group (SG, n = 17 (2050.2 ± 300.0 vs. 1780.3 ± 390.4m, p = 0.036 ABSTRACT Introduction: Smoking is one of the major causes of morbidity and mortality worldwide. Smokers have an increased risk of developing autonomic dysfunction, which can be evaluated by both heart rate variability (HRV) and heart rate recovery (HRRec). Most studies involving this analysis is performed on adults of advanced age and in condition of rest. Objectives: To compare the cardiac autonomic activity, at rest and during exercise in young men

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Cardiac autonomic dysfunction in obese subjects

Cited by 102 publications

References 0 publications

Electrocardiographic QTc interval: short-term weight loss effects

Electrocardiographic QTc interval: short-term weight loss effects

Insulin downregulates M2-muscarinic receptors in adult rat atrial cardiomyocytes: a link between obesity and cardiovascular complications

Comparação Da Modulação Autonômica Cardíaca Durante Esforço De Fumantes E Não Fumantes

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