Left ventricular hypertrophy and QT interval in obesity and in hypertension: effects of weight loss and of normalisation of blood pressure

Pontiroli, Antonio E.; Pizzocri, P.; Saibene, Alessandro; Girola, Andrea; Koprivec, Diana; Fragasso, Gabriele

doi:10.1038/sj.ijo.0802733

Cited by 49 publications

(37 citation statements)

References 56 publications

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“…[172][173][174] Of note, after the weight loss has ceased, the persistent effect of weight loss on blood pressure may not always be encountered. 175,176 The physician who evaluates a referred patient for hypertension should be very concerned about obese patients who admit habitual snoring, nocturnal gasping or choking, witnessed episodes of apnea, and daytime sleepiness and should consider sleep-disordered breathing. [177][178][179] …”

Section: Factors Leading To An Increase In Peripheral Vascular Resistmentioning

confidence: 99%

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Poirier¹,

Giles²,

Bray³

et al. 2006

Circulation

2,723

1,463

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Abstract-Obesity is becoming a global epidemic in both children and adults. It is associated with numerous comorbidities such as cardiovascular diseases (CVD), type 2 diabetes, hypertension, certain cancers, and sleep apnea/sleep-disordered breathing. In fact, obesity is an independent risk factor for CVD, and CVD risks have also been documented in obese children. Obesity is associated with an increased risk of morbidity and mortality as well as reduced life expectancy. Health service use and medical costs associated with obesity and related diseases have risen dramatically and are expected to continue to rise. Besides an altered metabolic profile, a variety of adaptations/alterations in cardiac structure and function occur in the individual as adipose tissue accumulates in excess amounts, even in the absence of comorbidities. Hence, obesity may affect the heart through its influence on known risk factors such as dyslipidemia, hypertension, glucose intolerance, inflammatory markers, obstructive sleep apnea/hypoventilation, and the prothrombotic state, in addition to as-yet-unrecognized mechanisms. On the whole, overweight and obesity predispose to or are associated with numerous cardiac complications such as coronary heart disease, heart failure, and sudden death because of their impact on the cardiovascular system. The pathophysiology of these entities that are linked to obesity will be discussed. However, the cardiovascular clinical evaluation of obese patients may be limited because of the morphology of the individual. In this statement, we review the available evidence of the impact of obesity on CVD with emphasis on the evaluation of cardiac structure and function in obese patients and the effect of weight loss on the cardiovascular system. (Circulation. 2006;113:898-918.)

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Section: Factors Leading To An Increase In Peripheral Vascular Resistmentioning

confidence: 99%

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Poirier¹,

Giles²,

Bray³

et al. 2006

Circulation

2,723

1,463

View full text Add to dashboard Cite

show abstract

“…[62][63][64] Of note, after the weight loss has ceased, the persistent effect of weight loss on blood pressure may not always be encountered. 65,66 …”

Section: Hypertensionmentioning

confidence: 99%

Obesity and Cardiovascular Disease

Poirier

Giles

Bray

et al. 2006

ATVB

724

310

View full text Add to dashboard Cite

Abstract-Obesity is becoming a global epidemic in both children and adults, and it is associated with numerous co-morbidities such as cardiovascular diseases (CVD), type 2 diabetes, hypertension, certain cancers, and sleep apnea/sleep-disordered breathing. In fact, is an independent risk factor for CVD and CVD risks have been also documented in obese children, and is associated with reduced life expectancy. A variety of adaptations/alterations in cardiac structure and function occur in the individual as adipose tissue accumulates in excess amount. As a whole, overweight/obesity predispose or is associated with numerous cardiac complications such as coronary heart disease, heart failure, and sudden death through its impact on the cardiovascular system.

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“…An abnormal ventricular repolarization, which predisposes to sudden death upon cardiac arrhythmia [3], may contribute to the increased mortality risk since obesity has been found to be associated with a high prevalence of a prolonged QT interval in electrocardiographic (ECG) recordings [4]. Furthermore, weight loss, in particular when induced by bariatric surgery, has been found to reduce QT interval (QTc) length in many studies (for overview see Table 1) [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. However, the validity of this observation has been challenged by one previous study [9] that demonstrated that the significance of QTc shortening upon weight loss gets lost when the QT interval is corrected for heart rate (HR) by using Fridericia or Framingham correction equation instead of the most commonly used Bazett equation.…”

Section: Introductionmentioning

confidence: 99%

QT Interval Shortening After Bariatric Surgery Depends on the Applied Heart Rate Correction Equation

et al. 2016

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Background A shortening of electrocardiographic QT interval has been observed in obese subjects after weight loss, but previous results may have been biased by inappropriate heart rate (HR) correction. Methods Electrocardiography (ECG) recordings of 49 (35 females) severely obese patients before and 12 months after Roux-en-Y gastric bypass (RYGB) surgery were analysed. QT interval (QTc) was calculated by using four different equations, i.e. Bazett, Fridericia, Framingham and Hodges. Results Irrespectively of the used correction formula, QTc interval length was reduced after the surgery (QTc Bazett −31 ± 18 ms; QTc Fridericia −12 ± 15 ms; QTc Framingham −14 ± 15 ms; QTc Hodges −9 ± 15 ms; all Ps < 0.001), but QTc Bazett reduction was significantly greater than the reduction in QTc calculated upon the other three equations (all Ps < 0.001). Moreover, changes in QTc Bazett (P < 0.001) but not in QTc Fridericia , QTc Framingham and QTc Hodges (all Ps > 0.05) were significantly correlated with concurrent changes in HR. Multivariate regression analyses revealed a significant independent association of serum insulin levels with QTc Fridericia , QTc Framingham and QTc Hodges values (all Ps < 0.05) preoperatively, whilst changes in QTc interval length after the surgery were not consistently associated to concurrent changes in metabolic traits. Conclusions Our data show that the extent of weight lossassociated QTc interval shortening largely depends on the applied HR correction equation and appears to be overestimated when the most popular Bazett's equation is used.

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Left ventricular hypertrophy and QT interval in obesity and in hypertension: effects of weight loss and of normalisation of blood pressure

Cited by 49 publications

References 56 publications

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Obesity and Cardiovascular Disease: Pathophysiology, Evaluation, and Effect of Weight Loss

Obesity and Cardiovascular Disease

QT Interval Shortening After Bariatric Surgery Depends on the Applied Heart Rate Correction Equation

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