Nutrition status, obesity and outcomes in patients with atrial fibrillation

Raposeiras‐Roubín, Sergio; Abu‐Assi, Emad; Castro, Andrea Lizancos; Pardal, Cristina Barreiro; Melendo-Viu, María; Fernández, María Cespón; Prieto, Sergio; Rosselló, Xavier; Ibáñez, Borja; Filgueiras‐Rama, David; Romo, Andrés Íñiguez

doi:10.1016/j.rec.2022.01.006

Cited by 5 publications

(3 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The initial hypotheses that will be tested through this platform will be the potential benefit of lifestyle interventions on the AF substrate in a population with MetS. AF is a common cardiac arrhythmia associated with an increased risk of stroke, heart failure, dementia, and cardiovascular mortality ( 15 , 16 ). In a large American study, 22% of visits to the emergency department were for AF, and this figure has increased by 30.7% from 2007 to 2014 ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

The Palma Echo Platform: Rationale and Design of an Echocardiography Core Lab

López

Rosselló

Romaguera

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe metabolic syndrome (MetS) is associated with increased cardiovascular morbidity and mortality. Characterization of cardiac structural and functional abnormalities due to the MetS can help recognize individuals who would benefit the most from preventive interventions. Transthoracic echocardiography (TTE) provides an opportunity to identify those abnormalities in a reproducible and cost-efficient manner. In research settings, implementation of protocols for the acquisition and analysis of TTE images are key to ensure validity and reproducibility, thus facilitating answering relevant questions about the association of the MetS with cardiac alterations.Methods and ResultsThe Palma Echo Platform (PEP) is a coordinated network that is built up to evaluate the underlying structural and functional cardiac substrate of participants with MetS. Repeated TTE will be used to evaluate 5-year changes in the cardiac structure and function in a group of 565 individuals participating in a randomized trial of a lifestyle intervention for the primary prevention of cardiovascular disease. The echocardiographic studies will be performed at three study sites, and will be centrally evaluated at the PEP core laboratory. Planned analyses will involve evaluating the effect of the lifestyle intervention on cardiac structure and function, and the association of the MetS and its components with changes in cardiac structure and function. Particular emphasis will be placed on evaluating parameters of left atrial structure and function, which have received more limited attention in past investigations. This PEP will be available for future studies addressing comparable questions.ConclusionIn this article we describe the protocol of a central echocardiography laboratory for the study of functional and structural alterations of the MetS.

show abstract

Section: Discussionmentioning

confidence: 99%

The Palma Echo Platform: Rationale and Design of an Echocardiography Core Lab

López

Rosselló

Romaguera

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…The prevalence of obesity is increasing in the general population and those with AF. In a recently published study in Spain which included 14,849 patients with AF, 46% of patients were obese ( 30 ). In the EORP-AF (EURObservational Research Programme AF) General Pilot Registry, among the 2,540 AF patients included, 42.7% were overweight and 29.0% were obese ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

The “obesity paradox” in patients with atrial fibrillation: Insights from the Gulf SAFE registry

Xie

Alsheikh‐Ali

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

BackgroundThe prognostic impact of obesity on patients with atrial fibrillation (AF) remains under-evaluated and controversial.MethodsPatients with AF from the Gulf Survey of Atrial Fibrillation Events (Gulf SAFE) registry were included, who were recruited from six countries in the Middle East Gulf region and followed for 12 months. A multivariable model was established to investigate the association of obesity with clinical outcomes, including stroke or systemic embolism (SE), bleeding, admission for heart failure (HF) or AF, all-cause mortality, and a composite outcome. Restricted cubic splines were depicted to illustrate the relationship between body mass index (BMI) and outcomes. Sensitivity analysis was also conducted.ResultsA total of 1,804 patients with AF and recorded BMI entered the final analysis (mean age 56.2 ± 16.1 years, 47.0% female); 559 (31.0%) were obese (BMI over 30 kg/m2). In multivariable analysis, obesity was associated with reduced risks of stroke/systematic embolism [adjusted odds ratio (aOR) 0.40, 95% confidence interval (CI), 0.18–0.89], bleeding [aOR 0.44, 95%CI, 0.26–0.74], HF admission (aOR 0.61, 95%CI, 0.41–0.90) and the composite outcome (aOR 0.65, 95%CI, 0.50–0.84). As a continuous variable, higher BMI was associated with lower risks for stroke/SE, bleeding, HF admission, all-cause mortality, and the composite outcome as demonstrated by the accumulated incidence of events and restricted cubic splines. This “protective effect” of obesity was more prominent in some subgroups of patients.ConclusionAmong patients with AF, obesity and higher BMI were associated with a more favorable prognosis in the Gulf SAFE registry. The underlying mechanisms for this obesity “paradox” merit further exploration.

show abstract

“…Both metabolic syndrome (MetS) and increased body weight are major risk factors for AF development and progression, since they have an impact on cardiovascular hemodynamics as well as on cardiac function and structure. [4][5][6] Several studies have shown that lifestyle changes controlling such risk factors may play a role in AF prevention. 3,7 In this line, a meta-analysis of randomised and observational studies reported that weight loss in obese individuals was associated with favourable hemodynamic effects, 8 whereas a post-hoc analysis of the Prevención con Dieta Mediterránea (PREDIMED) trial showed a reduced risk of newly-diagnosed AF in those allocated to a nutritional intervention fostering the adherence to a Mediterranean Diet (MedDiet) enriched with extra-virgin olive oil in comparison with those who were allocated to the advice on a low-fat diet.…”

Section: Introductionmentioning

confidence: 99%

Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome

Rossello,

Ramallal,

Romaguera

et al. 2023

Preprint

View full text Add to dashboard Cite

Aims. To evaluate the effect of an intensive lifestyle intervention (ILI) on the underlying structural and functional cardiac substrate of atrial fibrillation (AF) in overweight or obese people with metabolic syndrome (MetS). Methods. Participants of the PREDIMED-PLUS trial (n=6874) were randomised 1:1 to an ILI program based on an energy-reduced Mediterranean Diet, increased physical activity, and cognitive-behavioural weight management, or to a control intervention of low-intensity dietary advice. Transthoracic echocardiography (TTE) was evaluated in a subsample of 534 participants by a core lab at baseline, 3-year and 5-year follow-up. Mixed models were used to evaluate the effect of the ILI on left atrial (LA) structure and function. Results. In the subsample (n=534), mean age at inclusion was 66 years (SD 5 years), and 40% of the participants were women. Over the 5-year period, both groups experienced worsening of LA structure and function, with increases in LA volumes and stiffness index and decreases in LA longitudinal strain, LA function index and LA emptying fraction over time. Changes in the ILI and control group were not significantly different for any of the primary outcomes (LA emptying fraction: -0.95% (95%CI -0.93, -0.98) in control group, -0.97% (95%CI -0.94, -1.00) in ILI group, pbetween groups=0.80; LA longitudinal strain: 0.82% (95%CI 0.79, 0.85) in control group, 0.85% (95%CI 0.82, 0.89) in ILI group, pbetween groups=0.24) or any of the secondary outcomes. Conclusions. In overweight or obese people with MetS, an ILI had no impact on the underlying structural and functional cardiac substrate of AF, as assessed by transthoracic echocardiography.

show abstract

Nutrition status, obesity and outcomes in patients with atrial fibrillation

Cited by 5 publications

References 23 publications

The Palma Echo Platform: Rationale and Design of an Echocardiography Core Lab

The Palma Echo Platform: Rationale and Design of an Echocardiography Core Lab

The “obesity paradox” in patients with atrial fibrillation: Insights from the Gulf SAFE registry

Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome

Contact Info

Product

Resources

About