Beyond weight loss – cardiometabolic risk reduction

    Authors

    Keywords

    weight loss, cardiometabolic risk, cardiovascular disease, cardiac remodeling

    DOI

    https://doi.org/10.15836/ccar2016.500

    Full Text

    **Introduction:** Weight loss can result in reduction of multiple cardiovascular risk factors, as well as cardiac structural and functional remodeling. (1-3) **Patients and Methods:** We enrolled 79 obese patients (37 in control group, 42 in intensive weight loss program). All patients were followed in cardiology outpatient department for 12 months, with a 3-month follow-up period. They were all advised to improve life-style and diet habits. All patients underwent initial and final cardiovascular risk assessment, echocardiography, exercise stress testing, ECG Holter monitoring and 24-hour blood pressure monitoring. **Results:** We observed statistically significant improvement in LA and RA volumes, reduced ventricular mass, systolic blood pressure and improved functional capacity on treadmill test. Insulin resistance based on HOMA model also improved, with a significant fall in proinflammatory marker CRP. ECG Holter monitoring revealed significant reduction of AF episodes and SVPBs. Structural changes between groups were independent of the body surface area. **Conclusion:** Structured weight loss program leads to improved cardiometablic risk management, with reduced insulin resistance and modulation of inflammation. Significant reduction in cardiac volumes, blood pressure and added functional benefit was observed. Suppressed supraventricular arrhythmogenicity is hypothesized to reflect structural and electrical remodeling of the heart.

    Literature

    1. Abed HS, Wittert GA, Leong DP, Shirazi MG, Shirazi MG, Bahrami B, Middeldorp ME, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310(19):2050–60. https://doi.org/10.1001/jama.2013.280521
    2. Abed HS, Nelson AJ, Richardson JD, Worthley SG, Vincent A, Wittert GA, et al. Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation. Am Heart J. 2015;169(5):655–62.e2. https://doi.org/10.1016/j.ahj.2015.02.008
    3. Siri-Tarino PW, Krauss RM. Diet, lipids, and cardiovascular disease. Curr Opin Lipidol. 2016;27(4):323–8. https://doi.org/10.1097/MOL.0000000000000310
    Cardiologia Croatica
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    Beyond weight loss – cardiometabolic risk reduction

    Extended Abstract
    Issue10-11
    Published
    Pages500
    PDF via DOIhttps://doi.org/10.15836/ccar2016.500
    weight loss
    cardiometabolic risk
    cardiovascular disease
    cardiac remodeling

    Authors

    Martina Lovrić Benčić*ORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Jozo JelčićORCIDEndocrinology specialist private practice prim. dr. sc. Jozo Jelčić, Zagreb, Croatia
    Lada BradićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Tea ŠimončekORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Marina MihajlovićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Gregor EderORCIDSchool of Medicine, University of Zagreb, Zagreb, Croatia

    *Correspondence email: martina.lovric@zg.t-com.hr

    Full Text

    Introduction: Weight loss can result in reduction of multiple cardiovascular risk factors, as well as cardiac structural and functional remodeling. (1–3)

    Patients and Methods: We enrolled 79 obese patients (37 in control group, 42 in intensive weight loss program). All patients were followed in cardiology outpatient department for 12 months, with a 3-month follow-up period. They were all advised to improve life-style and diet habits. All patients underwent initial and final cardiovascular risk assessment, echocardiography, exercise stress testing, ECG Holter monitoring and 24-hour blood pressure monitoring.

    Results: We observed statistically significant improvement in LA and RA volumes, reduced ventricular mass, systolic blood pressure and improved functional capacity on treadmill test. Insulin resistance based on HOMA model also improved, with a significant fall in proinflammatory marker CRP. ECG Holter monitoring revealed significant reduction of AF episodes and SVPBs. Structural changes between groups were independent of the body surface area.

    Conclusion: Structured weight loss program leads to improved cardiometablic risk management, with reduced insulin resistance and modulation of inflammation. Significant reduction in cardiac volumes, blood pressure and added functional benefit was observed. Suppressed supraventricular arrhythmogenicity is hypothesized to reflect structural and electrical remodeling of the heart.

    Literature

    1. 1.
      Abed HS, Wittert GA, Leong DP, Shirazi MG, Shirazi MG, Bahrami B, Middeldorp ME, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310(19):2050–60.DOI
    2. 2.
      Abed HS, Nelson AJ, Richardson JD, Worthley SG, Vincent A, Wittert GA, et al. Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation. Am Heart J. 2015;169(5):655–62.e2.DOI
    3. 3.
      Siri-Tarino PW, Krauss RM. Diet, lipids, and cardiovascular disease. Curr Opin Lipidol. 2016;27(4):323–8.DOI