The myth of QT shortening by weight loss and physical training in obese subjects with coronary heart disease.
This study aims to describe the changes that a period of low-calorie diet and physical training determines in heart rate and in corrected QT (QTc) interval in obese patients with coronary heart disease (CHD) and to verify whether it is effective in shortening the QT interval using three different methods for QT correction. Two hundred and seventy obese white patients (162 males--60%) affected with stable CHD and treated with β-blockers were retrospectively studied in the setting of a program aimed at losing weight through training (aerobic activity + strength exercise) and diet (80% of estimated resting energy expenditure). Age was related to RR interval, QTc was related to left ventricular ejection fraction (EF) while sex exerted no effects. At the end of the study period heart rate decreased by 8.3% and noncorrected QT increased by 3.0%; QT corrected with the Bazett formula decreased by 0.7% (P = 0.007), QT corrected with the Fridericia formula increased by 0.5% (P = 0.023), whereas the modifications were nonsignificant when the Framingham correction was used. In conclusion, contrary to the current views, physical training and diet, which are effective in reducing heart rate, produced no clinically relevant change in the QT interval.
Gondoni
Luca A
LA
Unit of Cardiac Rehabilitation Ospedale San Giuseppe, IRCCS Istituto Auxologico Italiano, Verbania, Italy. gondoni@auxologico.it
Titon
Anna M
AM
Montano
Mariella
M
Caetani
Giulia
G
Nibbio
Ferruccio
F
Schwartz
Peter J
PJ
D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology*; D004038:Diet, Reducing; D004562:Electrocardiography / Q000592:standards; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000009:adverse effects; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards; D008297:Male; D008875:Middle Aged; D009229:Mythology; D009765:Obesity / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D012189:Retrospective Studies; D015431:Weight Loss / Q000502:physiology*