title: Major rapid weight loss induces changes in cardiac repolarization.
abstract: Obesity is associated with increased all-cause mortality, but weight loss may not decrease cardiovascular events. In fact, very low calorie diets have been linked to arrhythmias and sudden death. The QT interval is the standard marker for cardiac repolarization, but T-wave morphology analysis has been suggested as a more sensitive method to identify changes in cardiac repolarization. We examined the effect of a major and rapid weight loss on T-wave morphology.
  
  
  
  Twenty-six individuals had electrocardiograms (ECG) taken before and after eight weeks of weight loss intervention along with plasma measurements of fasting glucose, HbA1c, and potassium. For assessment of cardiac repolarization changes, T-wave Morphology Combination Score (MCS) and ECG intervals: RR, PR, QT, QTcF (Fridericia-corrected QT-interval), and QRS duration were derived. The participants lost on average 13.4% of their bodyweight. MCS, QRS, and RR intervals increased at week 8 (p<0.01), while QTcF and PR intervals were unaffected. Fasting plasma glucose (p<0.001) and HbA1c both decreased at week 8 (p<10(-5)), while plasma potassium was unchanged. MCS but not QTcF was negatively correlated with HbA1c (p<0.001) and fasting plasma glucose (p<0.01).
  
  
  
  Rapid weight loss induces changes in cardiac repolarization. Monitoring of MCS during calorie restriction makes it possible to detect repolarization changes with higher discriminative power than the QT-interval during major rapid weight loss interventions. MCS was correlated with decreased HbA1c. Thus, sustained low blood glucose levels may contribute to repolarization changes.
authors.affiliation: Laboratory of Experimental Cardiology, Departtment of Biomedical Sciences, University of Copenhagen, Denmark; Danish National Research Foundation Centre for Cardiac Arrhythmia, Denmark; Department of Clinical Neurophysiology, Glostrup Hospital, Denmark.
authors.forename: Esben
authors.initials: E
authors.lastname: Vedel-Larsen
authors.affiliation: NNF Center for Basic Metabolic Research, University of Copenhagen, Denmark; Endocrinology Research Section, Department of Biomedical Sciences, University of Copenhagen, Denmark.
authors.forename: Eva Winning
authors.initials: EW
authors.lastname: Iepsen
authors.affiliation: NNF Center for Basic Metabolic Research, University of Copenhagen, Denmark; Endocrinology Research Section, Department of Biomedical Sciences, University of Copenhagen, Denmark.
authors.forename: Julie
authors.initials: J
authors.lastname: Lundgren
authors.affiliation: Department of Health Science and Technology, Aalborg University, Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Graff
authors.affiliation: Department of Health Science and Technology, Aalborg University, Denmark.
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Struijk
authors.affiliation: NNF Center for Basic Metabolic Research, University of Copenhagen, Denmark.
authors.forename: Torben
authors.initials: T
authors.lastname: Hansen
authors.affiliation: NNF Center for Basic Metabolic Research, University of Copenhagen, Denmark; Endocrinology Research Section, Department of Biomedical Sciences, University of Copenhagen, Denmark.
authors.forename: Jens Juul
authors.initials: JJ
authors.lastname: Holst
authors.affiliation: Department of Endocrinology, Hvidovre Hospital, Denmark.
authors.forename: Sten
authors.initials: S
authors.lastname: Madsbad
authors.affiliation: NNF Center for Basic Metabolic Research, University of Copenhagen, Denmark; Endocrinology Research Section, Department of Biomedical Sciences, University of Copenhagen, Denmark.
authors.forename: Signe
authors.initials: S
authors.lastname: Torekov
authors.affiliation: Laboratory of Experimental Cardiology, Departtment of Biomedical Sciences, University of Copenhagen, Denmark. Electronic address: jkanters@sund.ku.dk.
authors.forename: Jørgen K
authors.initials: JK
authors.lastname: Kanters
mesh_terms: D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000503:physiopathology*; D001786:Blood Glucose / Q000378:metabolism*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015431:Weight Loss
chemical_list: D001786:Blood Glucose
keywords: Heart rate; Obesity; QRS duration; QT interval; T-wave morphology; Weight loss