Estimation of some myocardial electrical instability indexes in patients with obesity
Abstract. Cardiovascular diseases (CVD) are the leading cause of mortality worldwide. Obesity is a major risk factor for CVD and is associated with growing of overall mortality, as it potentially increases the risk of sudden cardiac death (SCD). Such indexes as increased QT dispersion and decreased heart rate variability (HRV) serve as markers of myocardial electrical instability (MEI) and independent risk factors for SCD development. The aim: to estimate certain MEI indexes in obese patients. Material and methods. The study included 62 patients divided into three groups: Group 1 – 14 healthy individuals, Group 2 – 19 patients diagnosed with stage I–III obesity, and Group 3 – 29 patients diagnosed with stage I–III obesity and type 2 diabetes mellitus. Clinical examination of the participants included questionnaire, blood pressure measurement, anthropometric assessment (height, weight, body mass index, waist and hip circumference), 24-hour electrocardiogram monitoring (EM-ECG). EM-ECG included assessment of heart rate, HRV parameters (avNN, pNN50, SDNNidx, SDNN, SDNNidx, RMSSD, VLF, LF, HF), QT interval. Results. Comparatively to healthy controls, patients in Group 2 showed a decrease in overall HRV parameters: SDNN by 86% and SDNNidx by 79% (p <0.05). In Group 3, SDNN, pNN50, and SDNNidx were reduced by 79, 42, and 72% (p <0.05), respectively, relative to healthy controls. Furthermore, comparatively to healthy controls, patients in group 2 showed a decrease in VLF and LF by 69 and 60% (p <0.05), while patients in group 3 showed a decrease in LF and HF by 52 and 38% (p <0.05), respectively. Conclusion. An analysis of EM-ECG parameters in patients included in the study revealed a decrease in HRV, most pronounced in those with combination of obesity and type 2 diabetes mellitus, which is considered to be a marker of MEI and a risk factor for SCD. In patients with obesity, decreased parasympathetic and increased sympathetic nervous system activity are observed. A decrease in LF and HF parameters reflects a nervous system imbalance in patients with a combination of obesity and type 2 diabetes mellitus.Stolyarova V.V., Orlova D.A., Yamashkina E.I., Esina M.V., Skopina Yu.A., Shokina S.V., Al- Katta K.H.K.
Keywords
obesity
cardiovascular disease
heart rate variability
myocardial electrical instability
References
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About the Authors
Vera V. Stolyarova, MD, Dr. Sci. (Medicine), professor, head of the Department of outpatient therapy, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.E-mail: vera_s00@mail.ru
ORCID: https://orcid.org/0000-0002-6164-4737. eLibrary SPIN: 4741-2242
Darya A. Orlova, MD, postgraduate student of N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.
E-mail: karpova-dasha1996@mail.ru
ORCID: https://orcid.org/0000-0001-6398-9993. eLibrary SPIN: 6893-8230
Yulia A. Skopina, MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.
E-mail: skopina@bk.ru
ORCID: https://orcid.org/0000-0001-7598-5690. eLibrary SPIN: 1791-6308
Svetlana V. Shokina, MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.
E-mail: sveti-kh@mail.ru
ORCID: https://orcid.org/0000-0001-8650-1778. eLibrary SPIN: 4548-4175
Ekaterina I. Yamashkina, MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.
E-mail: yamashkinamzrm@inbox.ru
ORCID: https://orcid.org/0009-0004-5092-7872. Scopus ID: 58798656000. eLibrary SPIN: 3440-1291
Marina V. Esina, MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy, N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.
E-mail: esina.marina.val@yandex.ru
ORCID: https://orcid.org/0000-0002-5318-2966. Scopus ID: 57217520624. eLibrary SPIN: 8753-5294
Kaid H.K. Al-Katta, MD, postgraduate student of N.P. Ogarev National Research Mordovia State University. Address: 430005, Saransk, 68 Bolshevistskaya St.
E-mail: qaid.khalid@yandex.ru
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