Evaluation of Changes in Ventricular Repolarization Parameters in Morbidly Obese Patients Undergoing Bariatric Surgery.
Electrocardiogram
Obesity
Repolarization
Surgery
Ventricular arrhythmia
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
29
12
2020
accepted:
24
03
2021
revised:
24
03
2021
pubmed:
16
4
2021
medline:
29
6
2021
entrez:
15
4
2021
Statut:
ppublish
Résumé
Weight loss after bariatric surgery has been associated with reduced cardiovascular mortality and overall mortality in obese patients. In this study, we aimed to analyze the changes between pre-operation and post-operation ventricular arrhythmia predictors in patients who underwent bariatric surgery. The study included 58 patients who underwent bariatric surgery. We measured QT max, QT min, QRS, JT, and Tp-e intervals, and we estimated Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, Tp-e/JTc rates, QTc max, QTc min, cQTd, and JTc intervals both pre-op and 6 months post-op. Heart rate, PR, QT max, QTc max, QTc min, cQTd, JTc, Tp-e, Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, and Tp-e/JTc values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months post-op. The results of our study showed that bariatric surgery had positive effects on the regression of ventricular repolarization parameters and the possible development of ventricular arrhythmia.
Sections du résumé
BACKGROUND
Weight loss after bariatric surgery has been associated with reduced cardiovascular mortality and overall mortality in obese patients. In this study, we aimed to analyze the changes between pre-operation and post-operation ventricular arrhythmia predictors in patients who underwent bariatric surgery.
MATERIALS AND METHODS
The study included 58 patients who underwent bariatric surgery. We measured QT max, QT min, QRS, JT, and Tp-e intervals, and we estimated Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, Tp-e/JTc rates, QTc max, QTc min, cQTd, and JTc intervals both pre-op and 6 months post-op.
RESULTS
Heart rate, PR, QT max, QTc max, QTc min, cQTd, JTc, Tp-e, Tp-e/QT max, Tp-e/QTc max, Tp-e/JT, and Tp-e/JTc values, which were close to the upper limit in the pre-op period, showed statistically significant decreases at 6 months post-op.
CONCLUSION
The results of our study showed that bariatric surgery had positive effects on the regression of ventricular repolarization parameters and the possible development of ventricular arrhythmia.
Identifiants
pubmed: 33856635
doi: 10.1007/s11695-021-05385-y
pii: 10.1007/s11695-021-05385-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3138-3143Références
Yılmaz M, Altın C, Tekin A, et al. Assessment of atrial fibrillation and ventricular arrhythmia risk after bariatric surgery by P wave/QT interval dispersion. Obes Surg. 2018;28(4):932–8. https://doi.org/10.1007/s11695-017-2923-z .
doi: 10.1007/s11695-017-2923-z
pubmed: 28900850
Chen H, Wang X, Xiong C, et al. The negative effects of obesity on heart, especially the electrophysiology of the heart. Artif Cells Nanomed Biotechnol. 2020;48(1):1055–62. https://doi.org/10.1080/21691401.2020.1770269 .
doi: 10.1080/21691401.2020.1770269
pubmed: 32696673
Aggarwal R, Harling L, Efthimiou E, et al. The effects of bariatric surgery on cardiac structure and function: a systematic review of cardiac imaging outcomes. Obes Surg. 2016;26(5):1030–40. https://doi.org/10.1007/s11695-015-1866-5 .
doi: 10.1007/s11695-015-1866-5
pubmed: 26328532
Ashrafian H, Darzi A, Athanasiou T. Bariatric surgery: can we afford to do it or deny doing it? Frontline Gastroenterol. 2011;2(2):82–9. https://doi.org/10.1136/fg.2010.002618 .
doi: 10.1136/fg.2010.002618
pubmed: 23814666
pmcid: 3695555
Nguyen NT, Nguyen B, Gebhart A, et al. Changes in the makeup of bariatric surgery: a national increase in use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–7. https://doi.org/10.1016/j.jamcollsurg.2012.10.003 .
doi: 10.1016/j.jamcollsurg.2012.10.003
pubmed: 23177371
Vrtovec B, Delgado R, Zewail A, et al. Prolonged QTc interval and high B-type natriuretic peptide levels together predict mortality in patients with advanced heart failure. Circulation. 2003;107(13):1764–9. https://doi.org/10.1161/01.CIR.0000057980.84624.95 .
doi: 10.1161/01.CIR.0000057980.84624.95
pubmed: 12665499
Chugh SS, Reinier K, Singh T, et al. Determinants of prolonged QT interval and their contribution to sudden death risk in coronary artery disease: the Oregon Sudden Unexpected Death Study. Circulation. 2009;119(5):663–70. https://doi.org/10.1161/CIRCULATIONAHA.108.797035 .
doi: 10.1161/CIRCULATIONAHA.108.797035
pubmed: 19171855
pmcid: 2734945
Tse G, Yan BP. Traditional and novel electrocardiographic conduction and repolarization markers of sudden cardiac death. Europace. 2017;19(5) Oxford University Press:712–21. https://doi.org/10.1093/europace/euw280 .
doi: 10.1093/europace/euw280
pubmed: 27702850
Ashrafian H, Le Roux CW, Darzi A, et al. Effects of bariatric surgery on cardiovascular function. Circulation. 2008;118(20) Lippincott Williams & Wilkins:2091–102. https://doi.org/10.1161/CIRCULATIONAHA.107.721027 .
doi: 10.1161/CIRCULATIONAHA.107.721027
pubmed: 19001033
Haslam DW, James WPT. Obesity. Lancet. 2005;366(9492):1197–209. https://doi.org/10.1016/S0140-6736(05)67483-1 .
doi: 10.1016/S0140-6736(05)67483-1
pubmed: 16198769
Poirier P, Eckel RH. Obesity and cardiovascular disease. Curr Atheroscler Rep. 2002;4(6):448–53. https://doi.org/10.1007/s11883-002-0049-8 .
doi: 10.1007/s11883-002-0049-8
pubmed: 12361492
Drenick EJ, Johnson DG, Bale GS, et al. Excessive mortality and causes of death in morbidly obese men. JAMA J Am Med Assoc. 1980;243(5):443–5. https://doi.org/10.1001/jama.1980.03300310031018 .
doi: 10.1001/jama.1980.03300310031018
Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Heart Study. Circulation. 1983;67(5):968–77. https://doi.org/10.1161/01.CIR.67.5.968 .
doi: 10.1161/01.CIR.67.5.968
pubmed: 6219830
Kannel WB, Plehn JF, Cupples LA. Cardiac failure and sudden death in the Framingham Study. Am Heart J. 1988;115(4):869–75. https://doi.org/10.1016/0002-8703(88)90891-5 .
doi: 10.1016/0002-8703(88)90891-5
pubmed: 3354416
Messerli FH. Overweight and sudden death. Increased ventricular ectopy in cardiopathy of obesity. Arch Intern Med. 1987;147(10):1725–8. https://doi.org/10.1001/archinte.147.10.1725 .
doi: 10.1001/archinte.147.10.1725
pubmed: 2444173
Spodick DH. Reduction of QT-interval imprecision and variance by measuring the JT interval. Am J Cardiol. 1992;70(1):103. https://doi.org/10.1016/0002-9149(92)91399-O .
doi: 10.1016/0002-9149(92)91399-O
pubmed: 1615849
Tsai SF, Houmsse M, Dakhil B, et al. QTc compared to JTc for monitoring drug-induced repolarization changes in the setting of ventricular pacing. Heart Rhythm. 2014;11(3):485–91. https://doi.org/10.1016/j.hrthm.2013.11.017 .
doi: 10.1016/j.hrthm.2013.11.017
pubmed: 24252288
Zulqarnain MA, Qureshi WT, O’Neal WT, et al. Risk of mortality associated with QT and JT intervals at different levels of QRS duration (from the Third National Health and Nutrition Examination Survey). Am J Cardiol. 2015;116(1):74–8. https://doi.org/10.1016/j.amjcard.2015.03.038 .
doi: 10.1016/j.amjcard.2015.03.038
pubmed: 25929581
pmcid: 5244257
Monitillo F. Ventricular repolarization measures for arrhythmic risk stratification. World J Cardiol. 2016;8(1):57. https://doi.org/10.4330/wjc.v8.i1.57 .
doi: 10.4330/wjc.v8.i1.57
pubmed: 26839657
pmcid: 4728107
Panikkath R, Reinier K, Uy-Evanado A, et al. Prolonged tpeak-to-tend interval on the resting ECG is associated with increased risk of sudden cardiac death. Circ Arrhythm Electrophysiol. 2011;4(4):441–7. https://doi.org/10.1161/CIRCEP.110.960658 .
doi: 10.1161/CIRCEP.110.960658
pubmed: 21593198
pmcid: 3157547
Inanir M, Sincer I, Erdal E, et al. Evaluation of electrocardiographic ventricular repolarization parameters in extreme obesity. J Electrocardiol. 2019;53:36–9. https://doi.org/10.1016/j.jelectrocard.2018.12.003 .
doi: 10.1016/j.jelectrocard.2018.12.003
Omran J, Bostick BP, Chan AK, et al. Obesity and ventricular repolarization: a comprehensive review. Prog Cardiovasc Dis. 2018;61(2) W.B. Saunders:124–35. https://doi.org/10.1016/j.pcad.2018.04.004 .
doi: 10.1016/j.pcad.2018.04.004
pubmed: 29698642
Omran J, Firwana B, Koerber S, et al. Effect of obesity and weight loss on ventricular repolarization: a systematic review and meta-analysis. Obes Rev. 2016;17(6):520–30. https://doi.org/10.1111/obr.12390 .
doi: 10.1111/obr.12390
pubmed: 26956255
Dekker JM, Schouten EG, Klootwijk P, et al. Association between QT interval and coronary heart disease in middle-aged and elderly men. The Zutphen Study. Circulation. 1994;90:779–85.
doi: 10.1161/01.CIR.90.2.779
Ferransini E, Galvan AQ, Gastaldelli A, et al. Insulin: new roles for an ancient hormone. Eur J Clin Investig. 1999;29:842–52.
doi: 10.1046/j.1365-2362.1999.00536.x
Li W, Bai Y, Sun K, et al. Patients with metabolic syndrome have prolonged corrected QT interval (QTc). Clin Cardiol. 2009;32:E93–9.
doi: 10.1002/clc.20416
Langen KJ, Ziegler D, Weise F, et al. Evaluation of QT interval length, QT dispersion and myocardial m-iodobenzylguanidine uptake in insulin-dependent diabetic patients with and without autonomic neuropathy. Clin Sci. 1997;93(4):325–33. https://doi.org/10.1042/cs0930325 .
doi: 10.1042/cs0930325
Vasheghani M, Sarvghadi F, Beyranvand MR, et al. The relationship between QT interval indices with cardiac autonomic neuropathy in diabetic patients: a case control study. Diabetol Metab Syndr. 2020;12(1) https://doi.org/10.1186/s13098-020-00609-0 .
Sökmen E, Özbek SC, Çelik M, et al. Changes in the parameters of ventricular repolarization during preapnea, apnea, and postapnea periods in patients with obstructive sleep apnea. PACE - Pacing Clin Electrophysiol. 2018;41(7):762–6. https://doi.org/10.1111/pace.13365 .
doi: 10.1111/pace.13365
pubmed: 29726590
Kilicaslan F et al. Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with moderate and severe obstructive sleep apnea. PACE - Pacing Clin Electrophysiol. 2012;35(8):966–72. https://doi.org/10.1111/j.1540-8159.2012.03439.x .
doi: 10.1111/j.1540-8159.2012.03439.x
pubmed: 22671991
Karacop and H. B. Karacop. Correlation between apnea–hypopnea index and Tp-Te interval, Tp-Te/QT, and Tp-Te/QTc ratios in obstructive sleep apnea. Ann Noninvasive Electrocardiol. 2020; https://doi.org/10.1111/anec.12809 .
Klimas J, Kruzliak P, Rabkin SW. Modulation of the QT interval duration in hypertension with antihypertensive treatment. Hypertens Res. 2015;38(7) Japanese Society of Hypertension:447–54. https://doi.org/10.1038/hr.2015.30 .
doi: 10.1038/hr.2015.30
pubmed: 25787045
Salles GF, Cardoso CRL, Leocadio SM, et al. Recent ventricular repolarization markers in resistant hypertension: are they different from the traditional QT interval? Am J Hypertens. 2008;21(1):47–53. https://doi.org/10.1038/ajh.2007.4 .
doi: 10.1038/ajh.2007.4
pubmed: 18091743
Drigny J, Gremeaux V, Guiraud T, et al. Long-term high intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med. 2013;56:356–70.
doi: 10.1016/j.rehab.2013.03.005
Grasser EK, Ernst B, Thurnheer M, et al. QT interval shortening after bariatric surgery depends on the applied heart rate correction equation. Obes Surg. 2017;27(4):973–82. https://doi.org/10.1007/s11695-016-2393-8 .
doi: 10.1007/s11695-016-2393-8
Giuliani C, Agostinelli A, Di Nardo F, et al. Automatic identification of the repolarization endpoint by computing the dominant T-wave on a reduced number of leads. Open Biomed Eng J. 2016;10(1):43–50. https://doi.org/10.2174/1874120701610010043 .
doi: 10.2174/1874120701610010043
pubmed: 27347218
pmcid: 4901195