Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Population and Laboratory Tests
2.2. 24-h Holter Monitoring
2.3. Statistical Analysis
3. Results
3.1. Clinical Characteristics of Study Populations
3.2. 24-h Holter Data
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Patients Before Bariatric Surgery (n = 50) | Patients After Bariatric Surgery (n = 50) | p Value |
---|---|---|---|
Heart rate 1 | |||
Mean heart rate (bpm) | 80 ± 11 | 74 ± 10 | <0.001 |
Minimal heart rate (bpm) * | 58 (39–89) | 51 (33–68) | <0.001 |
Maximal heart rate (bpm) | 127 (100–181) | 126 (105–167) | 0.21 |
Supraventricular arrhythmias (no., %) | |||
Supraventricular extrasystoles >100/24 h | 2 (4%) | 3 (6%) | 1.0 |
Non-sustained supraventricular tachycardia 2 | 5 (10%) | 15 (30%) | 0.02 |
Ventricular arrhythmias (no., %) | |||
Ventricular extrasystoles >100/24 h | 1 (2%) | 3 (6%) | 0.62 |
Non-sustained ventricular tachycardia 2 | 0 (0%) | 2 (4%) | 0.49 |
Time-domain heart rate variability parameters 3 | |||
SDNN (ms) * | 115 (73–225) | 145 (83–282) | <0.001 |
SDNN-I (ms) * | 41 (20–115) | 45 (24–122) | <0.001 |
SDANN (ms) * | 102 (68–181) | 134 (78–264) | <0.001 |
RMSSD (ms) * | 34 (15–122) | 33 (16–112) | 0.25 |
pNN50 (%) * | 8.6 (0.3–44.1) | 9.3 (0.4–50.8) | 0.06 |
HRV-index * | 16 (10–35) | 22 (11–38) | <0.001 |
Heart rate turbulence parameters 4 | |||
Turbulence onset (%) * | −2.1 (−7.5–−0.6) | −3.6 (−8.6–1.2) | 0.73 |
Turbulence slope (ms/RR) * | 7.5 (−3.1–21.8) | 8.6 (−3.1–43.8) | 0.22 |
Abnormal HRT (no.,%) | 3 (30%) | 2 (20%) | 0.80 |
Characteristic | Patients Before Bariatric Surgery (n = 50) | Patients After Bariatric Surgery (n = 50) | p Value |
---|---|---|---|
Body mass index (kg/m2) * | 43.9 (40.1–55.8) | 29.7 (19.6–43.9) | <0.001 |
Body mass index reduction (kg/m2) * | - | 14.7 (7.2–23.9) | - |
Waist circumference (cm) * | 139 (127–155) | 88 (67–124) | <0.001 |
Waist circumference reduction (cm) * | - | 53 (18–74) | - |
Additional diseases and parameters of carbohydrate metabolism | |||
Hypertension, n (%) | 27 (54%) | 16 (32%) | 0.04 |
Disorders of carbohydrate metabolism (together), (n,%) | 12 (24%) | 3 (6%) | 0.02 |
Type 2 diabetes mellitus, (n,%) | 1 (2%) | 1 (2%) | 1.0 |
Impaired glucose tolerance, (n,%) | 6 (12%) | 2 (4%) | 0.27 |
Impaired fasting glucose, (n,%) | 5 (10%) | 0 (0%) | 0.05 |
Fasting glucose level (mg/dl) * | 90 (76–118) | 85 (64–98) | <0.001 |
Fasting insulin level (uIU/mL) * | 13.0 (5.0–55.1) | 5.0 (1.4–11.9) | <0.001 |
QUICKI *,1 | 0.32 (0.27–0.39) | 0.38 (0.33–0.49) | <0.001 |
HOMA-IR *,2 | 3.1 (1.0–14.3) | 1.1 (0.3–2.4) | <0.001 |
Characteristic | Patients with Body Mass Index Reduction <14.7 kg/m2 (n = 24) | Patients with Body mass Index Reduction ≥14.7 kg/m2 (n = 26) | p value | Patients with Waist Circumference Reduction <53 cm (n = 24) | Patients with Waist Circumference Reduction ≥53 cm (n = 26) | p value |
---|---|---|---|---|---|---|
Hypertension, n (%) | 10 (42%) | 6 (23%) | 0.23 | 8 (33%) | 8 (31%) | 1.0 |
Parameters of carbohydrate metabolism | ||||||
Fasting glucose level (mg/dl) * | 86.6 ± 5.3 | 83.0 ± 6.8 | 0.05 | 85.7 ± 5.4 | 83.9 ± 7.0 | 0.33 |
Fasting insulin level (uIU/mL) * | 5.5 ± 2.3 | 5.2 ± 2.4 | 0.69 | 5.7 ± 2.6 | 5.0 ± 2.0 | 0.32 |
QUICKI *,1 | 0.38 ± 0.03 | 0.39 ± 0.04 | 0.40 | 0.38 ± 0.03 | 0.39 ± 0.03 | 0.47 |
HOMA-IR * 1 | 1.17 ± 0.51 | 1.09 ± 0.52 | 0.54 | 1.21 ± 0.56 | 1.06 ± 0.46 | 0.28 |
Time-domain heart rate variability parameters 1 | ||||||
SDNN (ms) * | 156 (99–244) | 138 (83–282) | 0.15 | 143 (99–269) | 143 (83-282) | 0.56 |
SDNN-I (ms) * | 54 (28–93) | 44 (24–122) | 0.23 | 49 (24–121) | 44 (26–96) | 0.78 |
SDANN (ms) * | 144 (95–257) | 129 (78–264) | 0.25 | 133 (95–223) | 133 (78–264) | 0.36 |
RMSSD (ms) * | 40 (19–90) | 28 (16–112) | 0.14 | 38 (16–112) | 33 (18–108) | 0.62 |
pNN50 (%) * | 11.9 (1.1–37.8) | 5.7 (0.4–50.8) | 0.12 | 10.3 (0.4–50.8) | 9.3 (0.8–40.9) | 0.47 |
HRV–index * | 23 (15–37) | 21.8 (11–38) | 0.38 | 27 (15–38) | 29 (11–36) | 0.26 |
Heart rate turbulence parameters | ||||||
Turbulence onset (%) | −2.9 ± 3.4 | −3.1 ± 2.9 | 0.93 | −3.5 ± 2.8 | -2.7 ± 3.2 | 0.51 |
Turbulence slope (ms/RR) | 12.6 ± 12.9 | 16.2 ± 14.2 | 0.58 | 17.3 ± 13.1 | 12.2 ± 13.8 | 0.62 |
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Bienias, P.; Rymarczyk, Z.; Domienik-Karłowicz, J.; Lisik, W.; Sobieraj, P.; Pruszczyk, P.; Ciurzyński, M. Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy. J. Clin. Med. 2021, 10, 2140. https://doi.org/10.3390/jcm10102140
Bienias P, Rymarczyk Z, Domienik-Karłowicz J, Lisik W, Sobieraj P, Pruszczyk P, Ciurzyński M. Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy. Journal of Clinical Medicine. 2021; 10(10):2140. https://doi.org/10.3390/jcm10102140
Chicago/Turabian StyleBienias, Piotr, Zuzanna Rymarczyk, Justyna Domienik-Karłowicz, Wojciech Lisik, Piotr Sobieraj, Piotr Pruszczyk, and Michał Ciurzyński. 2021. "Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy" Journal of Clinical Medicine 10, no. 10: 2140. https://doi.org/10.3390/jcm10102140