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Severe Obesity and P-Wave Dispersion: The Effect of Surgically Induced Weight Loss

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Abstract

Background

Recent data have shown that obesity is an important potential risk factor for atrial fibrillation (AF). The mechanism of development of AF in obesity patients is still unclear and may be related to atrial refractoriness heterogeneity. The aim of our study was to determine the influence of bariatric surgery with a consequent substantial weight loss on P-wave dispersion in morbidly obese population.

Methods

We enrolled in this study 40 severe obese patients, and 40 age-matched non-obese healthy subjects were also recruited as controls. All subjects underwent conventional 12-lead electrocardiography for the analysis of P-wave dispersion. All subjects underwent bariatric surgery and were resubmitted to electrocardiography, biochemical, and anthropometric examination within 12 months after intervention.

Results

Severe obese patients had greater values in P-wave duration and dispersion than the normal weight controls. Bariatric surgery reduced significantly P-wave dispersion. There was a significant correlation between decrease of atrial refractoriness heterogeneity and bariatric-surgery-induced weight loss.

Conclusions

In severe obese patients, surgically induced weight loss reduction is associated with significant decreased in P-wave dispersion. The reduction of the atrial refractoriness heterogeneity may be of clinical significance by reducing the risk of atrial fibrillation in morbidly obese subjects.

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References

  1. Perzanowski C, Ho AT, Jacobson AK. Increased P-wave dispersion predicts recurrent atrial fibrillation after cardioversion. J Electrocardiol 2005;38:43–6.

    Article  PubMed  Google Scholar 

  2. Li Z, Hertervig E, Carlson J, Johansson C, Olsson SB, Yuan S. Dispersion of refractoriness in patients with paroxysmal atrial fibrillation: evaluation with simultaneous endocardial recordings from both atria. J Electrocardiol 2002;35:227–34.

    Article  PubMed  Google Scholar 

  3. Li Z, Hertervig E, Yuan S, Yang Y, Lin Z, Olsson SB. Dispersion of atrial repolarization in patients with paroxysmal atrial fibrillation. Europace 2001;3:285–91.

    Article  PubMed  CAS  Google Scholar 

  4. Poirier P, Eckel RH. The heart and obesity. In: Fuster V, Alexander RW, King S, O’Rourke RA, Roberts R, Wellens HJJ, editors. Hurst’s the heart. New York: McGraw-Hill Companies; 2000. p. 2289–303.

    Google Scholar 

  5. Messerli FH, Nunez BD, Ventura HO, et al. Overweight and sudden death: increased ventricular ectopy in cardiopathy of obesity. Arch Intern Med 1987;147:1725–8.

    Article  PubMed  CAS  Google Scholar 

  6. Kannel WB, Plehn JF, Cupples LA. Cardiac failure and sudden death in the Framingham Study. Am Heart J 1988;115:869–75.

    Article  PubMed  CAS  Google Scholar 

  7. Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA 2004;292:2471–7.

    Article  PubMed  CAS  Google Scholar 

  8. Frost L, Hune LJ, Vestergaard P. Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study. Am J Med 2005;5:489–95.

    Article  Google Scholar 

  9. Russo V, Ammendola E, De Crescernzo I, Ricciardi D, Captano P, Topatino A, et al. Effect of weight loss following bariatric surgery on myocardial dispersion of repolarization in morbidly obese patients. Obes Surg 2007 Jul;17(7):857–65.

    Article  PubMed  Google Scholar 

  10. Benhamou G, Kasawat F, Harari H. Does bilio-intestinal bypass still have a role in the treatment of super-obesity? Obes Surg 1996 Apr;6(2):151–4.

    Article  PubMed  Google Scholar 

  11. Badiali M, D'Agostini A, Filippis AM, et al. Patency of anastomoses after bilio-intestinal bypass: radioisotope demonstration. Obes Surg 2001 Oct;11(5):615–8.

    Article  PubMed  CAS  Google Scholar 

  12. Gialafos JE, Dilaveris PE, Gialafos EJ, et al. P-wave dispersion: a valuable electrocardiographic marker for the prediction of paroxysmal lone atrial fibrillation. Ann Noninvasive Electrocardiol 1999;4:39–45

    Article  Google Scholar 

  13. Dilaveris PE, Andrikopoulos GK, Metaxas G, et al. Effects of ischemia on P wave dispersion and maximum P wave duration during spontaneous anginal episodes. Pacing Clin Electrophysiol 1999;22:1640–7.

    Article  PubMed  CAS  Google Scholar 

  14. Dilaveris PE, Gialafos EJ, Sideris S, et al. Simple electrocardiographic markers for the prediction of paroxysmal idiopathic atrial fibrillation. Am Heart J 1998;135:733–8.

    Article  PubMed  CAS  Google Scholar 

  15. Platonov PG, Carlson, J, Ingemansson MP, et al. Detection of inter-atrial conduction defects with unfiltered signal-averaged P-wave ECG in patients with lone atrial fibrillation. Europace 2000;2:32–41.

    Article  PubMed  CAS  Google Scholar 

  16. Messerli FH, Ventura HO, Reisin E, et al. Borderline hypertension and obesity: two prehypertensive states with elevated cardiac output. Circulation 1982;66:55–60.

    PubMed  CAS  Google Scholar 

  17. Kanoupakis E, Michaloudis D, Fraidakis O, et al. Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity. Obes Surg 2001 Oct;11(5):552–8.

    Article  PubMed  CAS  Google Scholar 

  18. Ruano M, Silvestre V, Castro R, García-Lescún MC, Rodríguez A, Marco A, et al. Morbid obesity, hypertensive disease and the renin–angiotensin–aldosterone axis. Obes Surg 2005 May;15(5):670–6.

    Article  PubMed  CAS  Google Scholar 

  19. Vaziri SM, Larson MG, Benjamin EJ, Levy D. Echocardiographic predictors of nonrheumatic atrial fibrillation: the Framingham Heart Study. Circulation 1994;89:724–30.

    PubMed  CAS  Google Scholar 

  20. Pritchett AM, Jacobsen SJ, Mahoney DW, Rodeheffer RJ, Bailey KR, Redfield MM. Left atrial volume as an index of left atrial size: a population-based study. J Am Coll Cardiol 2003;41:1036–43.

    Article  PubMed  Google Scholar 

  21. Vincent HK, Powers SK, Stewart DJ, Shanely RA, Demirel H, Naito H. Obesity is associated with increased myocardial oxidative stress. Int J Obes Relat Metab Disord 1999;23:67–74.

    Article  PubMed  CAS  Google Scholar 

  22. Zhou YT, Grayburn P, Karim A, et al. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci U S A 2000;97:1784–9.

    Article  PubMed  CAS  Google Scholar 

  23. Pelat M, Verwaerde P, Merial C, et al. Impaired atrial M(2)-cholinoceptor function in obesity-related hypertension. Hypertension 1999;34:1066–72.

    PubMed  CAS  Google Scholar 

  24. Kanagala R, Murali NS, Friedman PA, et al. Obstructive sleep apnea and the recurrence of atrial fibrillation. Circulation 2003;107:2589–94.

    PubMed  Google Scholar 

  25. Kanoupakis E, Michaloudis D, Fraidakis O, Parthenakis F, Vardas P, Melissas J. Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity. Obes Surg 2001 Oct;11(5):552–8.

    Article  CAS  Google Scholar 

  26. Esposito K, Marfella R, Gualdiero P, et al. Sympathovagal balance, nighttime blood pressure, and QT intervals in normotensive obese women. Obes Res 2003;5:653–9.

    Article  Google Scholar 

  27. Emdin M, Gastaldelli A, Muscelli E, et al. Hyperinsulinemia and autonomic nervous system dysfunction in obesity: effects of weight loss. Circulation 2000;4:513–9.

    Google Scholar 

  28. Blumberg VS, Alexander J. Obesity and the heart. In: Björntorp P, Brodoff BN, editors. Obesity. Philadelphia, PA: Lippincott;1992. pp. 517–531.

    Google Scholar 

  29. Alpert MA, Terry BE, Cohen MV, Fan T, Painter JA, Massey CV. The electrocardiogram in morbid obesity. Am J Cardiol 2000;85:908–10.

    Article  PubMed  CAS  Google Scholar 

  30. Arildsen H, May O, Christiansen EH, Damsgaard EM. Increased QT dispersion in patients with insulin-dependent diabetes mellitus. Int J Cardiol 1999;71:235–42.

    Article  PubMed  CAS  Google Scholar 

  31. Oikarinen L, Nieminen MS, Viitasalo M, et al. Relation of QT interval and QT dispersion to echocardiographic left ventricular hypertrophy and geometric pattern in hypertensive patients: the LIFE Study: the Losartan Intervention For Endpoint Reduction. J Hypertens 2001;19:1883–91.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Cardiology, Second University of Naples, Monaldi Hospital, Naples, Italy

    Vincenzo Russo, Ernesto Ammendola, Ilaria De Crescenzo, Lucio Santangelo & Raffaele Calabrò

  2. Eleventh Division of General Surgery and Bariatric Surgery, Second University of Naples, Naples, Italy

    Ludovico Docimo

  3. Via della Resistenza no. 48, 80021, Afragola (Naples), Italy

    Vincenzo Russo

Authors
  1. Vincenzo Russo
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  2. Ernesto Ammendola
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  3. Ilaria De Crescenzo
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  4. Ludovico Docimo
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  5. Lucio Santangelo
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  6. Raffaele Calabrò
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Correspondence to Vincenzo Russo.

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Russo, V., Ammendola, E., De Crescenzo, I. et al. Severe Obesity and P-Wave Dispersion: The Effect of Surgically Induced Weight Loss. OBES SURG 18, 90–96 (2008). https://doi.org/10.1007/s11695-007-9340-7

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  • DOI: https://doi.org/10.1007/s11695-007-9340-7

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