Estimation of some myocardial electrical instability indexes in patients with obesity
- Authors: Stolyarova V.V.1, Orlova D.A.1, Yamashkina E.I.1, Esina M.V.1, Skopina Y.A.1, Shokina S.V.1, Al-Katta K.H.1
-
Affiliations:
- N.P. Ogarev National Research Mordovia State University
- Issue: Vol 11, No 10 (2025)
- Pages: 174-180
- Section: ACTUAL ISSUES OF PHARMACOTHERAPY AND PREVENTIVE TREATMENT
- URL: https://journals.rcsi.science/2412-4036/article/view/375490
- DOI: https://doi.org/10.18565/therapy.2025.10.174-180
- ID: 375490
Cite item
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.
About the authors
Vera V. Stolyarova
N.P. Ogarev National Research Mordovia State University
Author for correspondence.
Email: vera_s00@mail.ru
ORCID iD: 0000-0002-6164-4737
SPIN-code: 4741-2242
MD, Dr. Sci. (Medicine), professor, head of the Department of outpatient therapy
Russian Federation, SaranskDarya A. Orlova
N.P. Ogarev National Research Mordovia State University
Email: karpova-dasha1996@mail.ru
ORCID iD: 0000-0001-6398-9993
SPIN-code: 6893-8230
MD, postgraduate student
Russian Federation, SaranskEkaterina I. Yamashkina
N.P. Ogarev National Research Mordovia State University
Email: yamashkinamzrm@inbox.ru
ORCID iD: 0009-0004-5092-7872
SPIN-code: 3440-1291
Scopus Author ID: 58798656000
MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy
Russian Federation, SaranskMarina V. Esina
N.P. Ogarev National Research Mordovia State University
Email: esina.marina.val@yandex.ru
ORCID iD: 0000-0002-5318-2966
SPIN-code: 8753-5294
Scopus Author ID: 57217520624
MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy
Russian Federation, SaranskYulia A. Skopina
N.P. Ogarev National Research Mordovia State University
Email: skopina@bk.ru
ORCID iD: 0000-0001-7598-5690
SPIN-code: 1791-6308
MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy
Russian Federation, SaranskSvetlana V. Shokina
N.P. Ogarev National Research Mordovia State University
Email: sveti-kh@mail.ru
ORCID iD: 0000-0001-8650-1778
SPIN-code: 4548-4175
MD, PhD (Medicine), associate professor, associate professor of the Department of outpatient therapy
Russian Federation, SaranskKaid H.K. Al-Katta
N.P. Ogarev National Research Mordovia State University
Email: qaid.khalid@yandex.ru
MD, postgraduate student
Russian Federation, SaranskReferences
- Бойцов С.А., Погосова Н.В., Аншелес А.А., Бадтиева В.А., Балахонова Т.В., Барбараш О.Л. c соавт. Кардиоваскулярная профилактика 2022. Российские национальные рекомендации. Российский кардиологический журнал. 2023;28(5):119–249. [Boytsov SA, Pogosova NV, Ansheles AA, Badtieva VA, Balakhonova TV, Barbarash OL et al. Cardiovascular prevention 2022. Russian national guidelines. Rossijskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2023;28(5):119–249 (In Russ.)]. EDN: EUDWYG. https://doi.org/10.15829/1560-4071-2023-5452
- GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–88. PMID: 30496103. PMCID: PMC6227606. https://doi.org/10.1016/S0140-6736(18)32203-7
- Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories: A systematic review and meta-analysis. JAMA. 2013;309(1):71–82. PMID: 23280227. PMCID: PMC4855514. https://doi.org/10.1001/jama.2012.113905
- GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1223–49. PMID: 33069327 PMCID: PMC7566194. https://doi.org/10.1016/S0140-6736(20)30752-2
- Schwartz MW, Seeley RJ, Zeltser LM, Drewnowski A, Ravussin E, Redman LM, Leibel RL. Obesity pathogenesis: An Endocrine Society scientific statement. Endocr Rev. 2017;38(4):267–96. PMID: 28898979. PMCID: PMC5546881. https://doi.org/10.1210/er.2017-00111
- Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA et al.; American College of Cardiology/American Heart Association Task Force on Practice Guidelines; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and The Obesity Society. Journal of the J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023. PMID: 24239920. https://doi.org/10.1016/j.jacc.2013.11.004
- Bastien M, Poirier P, Lemieux I, Despres JP. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis. 2014;56(4):369–81. PMID: 24438728. https://doi.org/10.1016/j.pcad.2013.10.016
- Hookana E, Junttila MJ, Puurunen VP, Tikkanen JT, Kaikkonen KS, Kortelainen ML et al. Causes of nonischemic sudden cardiac death in the current era. Heart Rhythm. 2011;8(10):1570–75. PMID: 21740887. https://doi.org/10.1016/j.hrthm.2011.06.031
- Ревишвили А.Ш., Неминущий Н.М., Баталов Р.Е., Гиляров М.Ю., Голицын С.П., Давтян К.В. с соавт. Всероссийские клинические рекомендации по контролю над риском внезапной остановки сердца и внезапной сердечной смерти, профилактике и оказанию первой помощи. Вестник аритмологии. 2017;(89):2–104. [Revishvili ASh, Neminuschiy NM, Batalov RE, Gilyarov MYu, Golitsyn SP, Davtyan KV et al. All Russian clinical guidelines for controlling the risk of sudden cardiac arrest and sudden cardiac death, prevention and first aid. Vestnik aritmologii = Bulletin of Arrhythmology. 2017;(89):2–104 (In Russ.)]. EDN: YPIPVV.
- Громова О.И., Александрова С.А., Макаренко В.Н., Голухова Е.З. Современные предикторы жизнеугрожающих аритмий. Креативная кардиология. 2012;(2):30–46. [Gromova OI, Aleksandrova SA, Makarenko VN, Golukhova EZ. Modern predictors of life-threatening arrhythmias. Kreativnaya kardiologiya = Creative Cardiology. 2012;(2):30–46 (In Russ.)]. EDN: QBWZLT.
Supplementary files
