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Evaluation of Changes in Ventricular Repolarization Parameters in Morbidly Obese Patients Undergoing Bariatric Surgery

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Abstract

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.

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References

  1. 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.

    Article  PubMed  Google Scholar 

  2. 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.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  5. 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.

    Article  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  PubMed  Google Scholar 

  10. Haslam DW, James WPT. Obesity. Lancet. 2005;366(9492):1197–209. https://doi.org/10.1016/S0140-6736(05)67483-1.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. 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.

    Article  CAS  Google Scholar 

  13. 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.

    Article  CAS  PubMed  Google Scholar 

  14. 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.

    Article  CAS  PubMed  Google Scholar 

  15. 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.

    Article  CAS  PubMed  Google Scholar 

  16. 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.

    Article  CAS  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  19. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 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.

    Article  PubMed  PubMed Central  Google Scholar 

  21. 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.

    Article  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. 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.

    Article  CAS  PubMed  Google Scholar 

  24. 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.

    Article  CAS  Google Scholar 

  25. Ferransini E, Galvan AQ, Gastaldelli A, et al. Insulin: new roles for an ancient hormone. Eur J Clin Investig. 1999;29:842–52.

    Article  Google Scholar 

  26. Li W, Bai Y, Sun K, et al. Patients with metabolic syndrome have prolonged corrected QT interval (QTc). Clin Cardiol. 2009;32:E93–9.

    Article  Google Scholar 

  27. 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.

    Article  CAS  Google Scholar 

  28. 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.

  29. 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.

    Article  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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.

  32. 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.

    Article  CAS  PubMed  Google Scholar 

  33. 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.

    Article  PubMed  Google Scholar 

  34. 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.

    Article  CAS  Google Scholar 

  35. 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.

    Article  Google Scholar 

  36. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Correspondence to Ersin Ibisoglu.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Ibisoglu, E., Tekin, D.D.N., Kızılırmak, F. et al. Evaluation of Changes in Ventricular Repolarization Parameters in Morbidly Obese Patients Undergoing Bariatric Surgery. OBES SURG 31, 3138–3143 (2021). https://doi.org/10.1007/s11695-021-05385-y

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