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Dimala CA, Nso N, Wasserlauf J, Njei B. Electrocardiographic abnormalities in patients with metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102580. [PMID: 38653446 DOI: 10.1016/j.cpcardiol.2024.102580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 04/20/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION This study review aimed to consolidate current knowledge on the electrocardiographic abnormalities observed in patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD). METHODS This was a systematic review of studies on the association between MASLD and electrocardiographic abnormalities, published between January 1, 1946, and October 31, 2023. Data from eligible studies were extracted, analyzed, synthesized, and summarized. RESULTS We evaluated a total of 27 studies with 8,607,500 participants overall and 1,005,101 participants with MASLD. There was a statistically significant association between MASLD and prevalent atrial fibrillation (pooled OR: 1.34 95 % CI: 1.20-1.49, p < 0.001, n = 12), shorter QRS duration (pooled SMD: -0.073, 95 % CI: -0.144 - -0.001, n = 2, p = 0.048, n = 2), QTc prolongation (p < 0.001, n = 2), LVH (pooled OR: 1.48, 95 % CI: 1.25-1.75, p < 0.001, n = 3), low voltage (p < 0.001, n = 1), ST changes (OR: 1.41, 95 % CI: 1.04-1.91, p = 0.027, n = 1), T wave inversion (p < 0.001, n = 1), axis deviation (OR: 3.21, 95 % CI: 1.99-5.17, p < 0.001, n = 1), conduction defect (OR: 2.79, 95 % CI: 1.83-4.26, p < 0.001, n = 1) and bundle branch block (OR: 2.90, 95 % CI: 1.82-4.61, p < 0.001, n = 1), any persistent heart block (p < 0.001, n = 1), fragmented QRS (p < 0.001, n = 1), and p wave dispersion (p < 0.001, n = 1) CONCLUSION: MASLD is associated with multiple ECG abnormalities which are potential markers of early cardiac involvement, highlighting the multisystemic nature of MASLD. These specific ECG abnormalities could be used in screening and management algorithms to improve cardiac risk stratification in MASLD patients. PROSPERO REGISTRATION CRD42023477501.
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Affiliation(s)
- Christian Akem Dimala
- Division of Cardiovascular Medicine, University of Texas Medical Branch, 301 University Blvd., 5.106 John Sealy Annex, Galveston, TX 77555-0553, United States.
| | - Nso Nso
- Division of Cardiology, University of Chicago (Northshore), Evanston, IL, United States
| | - Jeremiah Wasserlauf
- Cardiovascular Institute, North Shore University Health System, Evanston, IL, United States
| | - Basile Njei
- Yale University School of Medicine, New Haven, CT, United States
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Wang Y, Zhang T, Zhang Y, Huang Z, Guo Q, Lan C, Deng L, Liu Y, Wu M, Yu P, Lin L, Liao Y. Interrelationships among abnormal P-wave axis, metabolic syndrome and its components, and mortality in US adults. J Electrocardiol 2024; 84:137-144. [PMID: 38696980 DOI: 10.1016/j.jelectrocard.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/10/2024] [Accepted: 04/18/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with increased rates of cardiovascular disease and mortality and is linked to abnormal electrocardiogram (ECG) parameters. We aimed to explore the relationships and interactions among MetS and its components, abnormal P-wave axis (aPWA), and mortality rates. METHODS We analyzed data from 7526 adult participants with sinus rhythm recruited from the National Health and Nutrition Examination Survey III. MetS was classified based on the NCEP ATP III-2005 definition. aPWA included all P-wave axis outside 0-75°. The National Death Index was utilized to identify survival status. Hazard ratios (HRs) and 95% confidence intervals (CIs) categorized by aPWA, MetS, and their components were analyzed using Cox proportional hazards models to investigate all-cause and cardiovascular mortalities. RESULTS Within a median follow-up period of 20.76 years, 4686 deaths were recorded, of which 1414 were attributable to cardiovascular disease. Participants with both MetS and aPWA had higher all-cause (HR: 1.45, 95% CI: 1.29-1.64, interaction P = 0.043) and cardiovascular (HR: 1.36, 95% CI: 1.02-1.79, interaction P-value = 0.058) mortality rates than participants without MetS and with a normal P-wave axis. Participants with the greatest number of MetS components and aPWA had a higher risk of all-cause mortality (HR: 1.70, 95% CI: 1.13-2.55, P = 0.011). CONCLUSIONS Individuals with both aPWA and MetS have a higher risk of mortality, and those with a greater number of MetS components and aPWA have a higher risk of all-cause mortality. These findings highlight the significance of integrating ECG characteristics with metabolic health status in clinical assessment.
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Affiliation(s)
- Yun Wang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Ting Zhang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Yanbin Zhang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Zhibiao Huang
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Qian Guo
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Caifeng Lan
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Lin Deng
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Yuchen Liu
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Mingxin Wu
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Pei Yu
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Lijun Lin
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China
| | - Ying Liao
- Longyan First Affiliated Hospital of Fujian Medical University, Longyan 364000, China.
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Zaki SM, El Karsh DS, Yousef S, Jamal T, Alsaddah A. The Association Between Components of Metabolic Syndrome and Abnormal Electrocardiograms in the Saudi Population: A Retrospective Study. Cureus 2024; 16:e56782. [PMID: 38650800 PMCID: PMC11034621 DOI: 10.7759/cureus.56782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/25/2024] Open
Abstract
REVIEW Saudi Arabia has a high metabolic syndrome (MetS) prevalence. Having MetS increases the risk of cardiovascular disease (CVD), CVD mortality, and myocardial infarction (MI). There is a lack of information regarding MetS and electrocardiogram (ECG) abnormalities in Saudi Arabian populations. Further, it is unclear to what extent MetS components are associated with abnormal ECGs in Saudi populations. AIM We investigated whether ECG abnormalities and MetS are associated with Saudi adults. Furthermore, we assessed the relationship between ECG abnormalities and the components of MetS based on the age and gender of the individuals. Materials and methods: A retrospective study was conducted at Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia, on 208 patients with MetS. Participants' clinical and laboratory data were examined. A detailed analysis of the ECG was performed. ECG abnormalities were divided into minor and major abnormalities based on Novacode criteria. In addition to ischemic ECG findings, the ECG showed prolonged PR intervals, prolonged P duration, prolonged QRS duration, and prolonged QTc intervals. Results: One hundred and thirty-seven participants (65.9%) had elevated fasting blood glucose (FBS), 129 had central obesity (62%), 93 had high blood pressure (BP) (44.7%), 74 had elevated triglycerides (35.6%), and 49 had low high-density lipoprotein (23.6%). An abnormal ECG was found in 86 (41.3%) participants. It consisted of ischemic ECGs, atrioventricular (AV) block (first and second degrees), bundle branch block (right bundle branch block [RBBB], left bundle branch block [LBBB], RBBB with left anterior hemiblock, RBBB with right anterior hemiblock), arrhythmias (premature ventricular contractions [PVCs], premature atrial complexes [PACs], atrial fibrillation [AF], sinus bradycardia, sinus arrhythmia), prolonged QTc, prolonged PR interval, and prolonged QRS duration. There were 29 (13.9%) cases with multiple ECG abnormalities, 57 (27.4%) had one abnormal ECG, 42 (20.2%) had minor abnormal ECGs, and 44 (21.2%) had major abnormal ECGs. Middle-aged and elderly males accounted for the majority of these ECG changes. In the central obesity group, 22 participants (10.6%) had ischemic ECGs, 18 (8.7%) had prolonged QTc, 10 (4.8%) had first-degree AV block, 6 (2.9%) had sinus bradycardia, 7 (3.4%) had RBBB, 4 (1.9%) had LBBB, 3 (1.4%) had PVCs, 2 (1%) had ventricular preexcitation, and one (0.5%) had PACs. An elevated FBS group included 19 participants (9.1%) with an ischemic ECG, 18 (8.7%) with a prolonged QTc, 11 (5.3%) with a first-degree AV block, 9 (4.3%) with sinus bradycardia, 6 (2.9%) with slight ST-T abnormality, 5 (2.4%) with RBBB, and 5 (2.4%) with LBBB. Finally, one (0.5%) of these patients had second-degree AV block, RBBB with left anterior hemiblock, left anterior hemiblock, PVCs, AF, ventricular preexcitation, and sinus arrhythmia for each. CONCLUSION Saudi Arabian populations with MetS were strongly associated with abnormal ECG findings, particularly ischemic ECG findings, AV block (first and second degrees), and BBB (RBBB, LBBB). Middle-aged and elderly males accounted for the majority of these ECG changes. The most important factors contributing to ECG changes were elevated FBS and central obesity.
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Affiliation(s)
- Sherif M Zaki
- Anatomy, Fakeeh College for Medical Sciences, Jeddah, SAU
| | | | - Shahad Yousef
- Anatomy, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Taif Jamal
- Anatomy, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Alaa Alsaddah
- Anatomy, Fakeeh College for Medical Sciences, Jeddah, SAU
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Farhadi A, Emamat H, Nemati R, Marzban M, Shafiee G, Nabipour I, Ostovar A, Jalaliyan Z, Malekizadeh H, Larijani B. The association between continuous metabolic syndrome score and its components with electrocardiographic abnormalities in community-dwelling older adults: the Bushehr elderly health (BEH) program. BMC Cardiovasc Disord 2024; 24:81. [PMID: 38297215 PMCID: PMC10829232 DOI: 10.1186/s12872-024-03733-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/17/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) known as a risk factor for cardiovascular diseases (CVDs) has developed into a major source of health issue, especially for the elderly. In the present study, we investigated the association between continuous MetS (cMetS) score and its components with electrocardiographic (ECG) abnormalities in the community-dwelling older adults. METHODS This cross-sectional study is derived from the second phase of BEH cohort study which is conducted on individuals aged over 60 years old. Standard 12-lead ECGs were recorded and coded by qualified physicians and continuous values of metabolic syndrome risk scores (cMetS) were measured. Data regarding socio-demographic, medical history, and lifestyle variables were collected by trained interviewers. The multinomial regression analysis was used to investigate the relationship between cMetS and its components with ECG abnormalities in the included participants. RESULTS 2426 individuals (mean age ± standard deviation: 69.30 ± 6.33 years) were included in the final analysis. Overall, 22.5% of the participants showed ECG abnormalities. Among these, 8.0% (n = 139) of participants had minor and 14.6% (n = 354) had major ECG abnormalities. In the final models, cMetS (OR = 1.04), mean arterial pressure (MAP((OR = 1.01), and higher fasting blood glucose (FBG) (OR = 1.01) increased the risk of ECG abnormalities (p < 0.05). Also, cMetS (OR = 1.05) and MAP (OR = 1.02) were associated with an increased risk of major ECG abnormalities (p < 0.05). CONCLUSION MetS and MAP were significantly associated with ECG abnormalities. The results of the present study suggest that ECG screening in the older population with MetS could potentially help to detect those at the higher risk of CVDs.
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Affiliation(s)
- Akram Farhadi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hadi Emamat
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Reza Nemati
- Department of Medical Emergencies, School of Allied Medical Sciences, Bushehr University of Medical Sciences, Bushehr, Iran
- Clinical Research Development Center, The Persian Gulf Martyrs Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Maryam Marzban
- Department of Biostatistics and Epidemiology, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran.
- Statistical Genetics Lab, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hasan Malekizadeh
- School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Delolmo-Romero S, Correa-Rodríguez M, Sánchez-Martínez MC, Gil-Gutiérrez R, Ortego-Centeno N, Rueda-Medina B. Social Health and Its Influence on Metabolic Health Among a Rural Population: A Cross-Sectional Study. Clin Nurs Res 2024; 33:9-18. [PMID: 37382362 DOI: 10.1177/10547738231184935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
The aim of this study was to estimate the prevalence of metabolic syndrome (MetS) in a Spanish rural population and assess differences in prevalence according to loneliness level, social isolation, and social support. This is a cross-sectional study of 310 patients. MetS was defined by National Cholesterol Education Program-Third Adult Treatment Panel. The UCLA (University of California, Los Angeles) Loneliness Scale, Multidimensional Scale of Social Support, and Lubben Social Network Scale were used to assess loneliness, perceived social support, and social isolation. Almost half of the participants fulfilled MetS diagnosis criteria. Subjects with MetS showed significantly higher levels of loneliness, less social support, and greater social isolation. Systolic blood pressure was significantly higher in socially isolated rural adults. Environmental factors may play a key role in the prevalence of MetS, so specific screening and prevention programs could help health professionals prevent the increasing rates of MetS in rural populations under these socially specific conditions of vulnerability.
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Affiliation(s)
- Sara Delolmo-Romero
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
| | | | - Rocío Gil-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
| | - Norberto Ortego-Centeno
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Department of Medicine, Faculty of Medicine, University of Granada, Spain
| | - Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
- Instituto de Investigación Biosanitaria IBS GRANADA, Spain
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6
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Moradpour F, Karimi Z, Fatemi Z, Moradi Y, Khosravi MR, Shokri A, Karimzadeh M. Prevalence of metabolic syndrome and its association with oral health: First results from the Kurdish cohort study. Health Sci Rep 2023; 6:e1602. [PMID: 37841941 PMCID: PMC10568541 DOI: 10.1002/hsr2.1602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Investigate the association between oral and dental health (ODH) and metabolic syndrome (MetS) in adults aged 35-70 years. Methods The study utilized data from the enrollment phase of Dehgolan prospective cohort study in the west of Iran. A cross-sectional assessment was conducted on a total of 3996 participants, involving a comprehensive oral examination and the assessment of their oral hygiene behavior (ODH). MetS was defined according to the updated National Cholesterol Education Program Adult Treatment Panel III. Logistic regression used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for sociodemographic characteristics. Results MetS was more prevalent among those who not daily brushing and flossing. Participants with missing teeth (MT) show higher prevalent of MetS. Being female, lower age, illiteracy, family history of diabetes, low physical activity, and salt at table were independently associated with increase odds of MetS (p < 0.05). Odds of MetS were significantly decreased with use flossing (OR = 0.75; CI = 0.60-0.93), decayed (OR = 0.83; CI = 0.72-0.97), filled (OR = 0.84; CI = 0.71-0.99), and increased with MT (OR = 1.45; CI = 1.16-1.81) as long as adjusted for ODH factors. When other potential confounder such as sociodemographic, personal and nutritional habits were adjusted, daily flossing was the only factor that still statistically decreased (OR = 0.79; CI = 0.62-0.99) the odds of MetS. Conclusion Daily flossing was the only factor that independently associated with MetS. Relationship of other ODH factors with Mets were confounded by sociodemographic characteristics of the participants.
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Affiliation(s)
- Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Zahra Karimi
- Vice Chancellor for Research and TechnologyKurdistan University of Medical SciencesSanandajIran
| | - Zeinab Fatemi
- Vice Chancellor for Health AffairsKurdistan University of Medical SciencesSanandajIran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of MedicineKurdistan University of Medical SciencesSanandajIran
| | | | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health DevelopmentKurdistan University of Medical SciencesSanandajIran
| | - Mohammad Karimzadeh
- Department of Epidemiology and Biostatistics, Faculty of MedicineKurdistan University of Medical SciencesSanandajIran
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7
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Bagheri M, Nouri M, Homayounfar R, Akhlaghi M. Association between adherence to the Mediterranean diet with cardiometabolic risk factors: a cross-sectional study on PERSIAN cohort study in Fasa. Sci Rep 2023; 13:14870. [PMID: 37684269 PMCID: PMC10491824 DOI: 10.1038/s41598-023-41935-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 09/04/2023] [Indexed: 09/10/2023] Open
Abstract
The relationship between Mediterranean diet and obesity-related markers is a matter of debate. We investigated the association between adherence to the Mediterranean diet and anthropometric indices, body composition, and cardiometabolic risk factors in Iranian population. The cross-sectional study was performed on data of 3386 participants from Fasa PERSIAN cohort study. The Mediterranean diet score (MDS) was calculated based on consumption of 11 food groups (unrefined cereals, potatoes, fruits, vegetables, legumes, fish, red meat, poultry, dairy, olive oil, and alcoholic beverages). The association between MDS and cardiometabolic risk factors was examined by linear regression analysis. MDS was inversely associated with waist circumference (β = - 1.11; P = 0.033), waist-to-hip ratio (β = - 0.007; P = 0.011), waist-to-height ratio (β = - 0.009; P = 0.015), fasting glucose (β = - 3.59; P = 0.001), and HDL-cholesterol (β = - 0.96; P = 0.031) in unadjusted model. After adjusting for energy intake, the associations of MDS with markers of abdominal obesity and HDL-cholesterol disappeared. In fully adjusted model, MDS showed inverse relationships with waist-to-hip ratio (β = - 0.005; P = 0.037) and fasting glucose (β = - 2.71; P = 0.013). In conclusion, MDS showed an inverse relationship with fasting glucose and waist-to-hip ratio. Since energy intake increased along with increasing MDS, adherence to the Mediterranean diet may associate with lower abdominal obesity and better glycemic control if an energy-controlled Mediterranean diet is used.
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Affiliation(s)
- Milad Bagheri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, Shiraz, Iran
| | - Mehran Nouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, Shiraz, Iran
- Students' Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Homayounfar
- Non-Communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, Shiraz, Iran.
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Homayounfar R, Farjam M, Bahramali E, Sharafi M, Poustchi H, Malekzadeh R, Mansoori Y, Naghizadeh MM, Vakil MK, Dehghan A. Cohort Profile: The Fasa Adults Cohort Study (FACS): a prospective study of non-communicable diseases risks. Int J Epidemiol 2023:6967048. [PMID: 36592077 DOI: 10.1093/ije/dyac241] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/22/2022] [Indexed: 01/03/2023] Open
Affiliation(s)
- Reza Homayounfar
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ehsan Bahramali
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Sharafi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yaser Mansoori
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Mohammad Kazem Vakil
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
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9
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Yazdanpanah MH, Naghizadeh MM, Sayyadipoor S, Farjam M. The best QT correction formula in a non-hospitalized population: the Fasa PERSIAN cohort study. BMC Cardiovasc Disord 2022; 22:52. [PMID: 35172723 PMCID: PMC8851728 DOI: 10.1186/s12872-022-02502-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/08/2022] [Indexed: 01/08/2023] Open
Abstract
Background QT interval as an indicator of ventricular repolarization is a clinically important parameter on an electrocardiogram (ECG). QT prolongation predisposes individuals to different ventricular arrhythmias and sudden cardiac death. The current study aimed to identify the best heart rate corrected QT interval for a non-hospitalized Iranian population based on cardiovascular mortality.
Methods Using Fasa PERSIAN cohort study data, this study enrolled 7071 subjects aged 35–70 years. Corrected QT intervals (QTc) were calculated by the QT interval measured by Cardiax® software from ECGs and 6 different correction formulas (Bazett, Fridericia, Dmitrienko, Framingham, Hodges, and Rautaharju). Mortality status was checked using an annual telephone-based follow-up and a minimum 3-year follow-up for each participant. Bland–Altman, QTc/RR regression, sensitivity analysis, and Cox regression were performed in IBM SPSS Statistics v23 to find the best QT. Also, for calculating the upper and lower limits of normal of different QT correction formulas, 3952 healthy subjects were selected. Results In this study, 56.4% of participants were female, and the mean age was 48.60 ± 9.35 years. Age, heart rate in females, and QT interval in males were significantly higher. The smallest slopes of QTc/RR analysis were related to Fridericia in males and Rautaharju followed by Fridericia in females. Thus, Fridericia’s formula was identified as the best mathematical formula and Bazett’s as the worst in males. In the sensitivity analysis, however, Bazett’s formula had the highest sensitivity (23.07%) among all others in cardiac mortality. Also, in the Cox regression analysis, Bazett’s formula was better than Fridericia’s and was identified as the best significant cardiac mortality predictor (Hazard ratio: 4.31, 95% CI 1.73–10.74, p value = 0.002). Conclusion Fridericia was the best correction formula based on mathematical methods. Bazett’s formula despite its poorest performance in mathematical methods, was the best one for cardiac mortality prediction. Practically, it is suggested that physicians use QTcB for a better evaluation of cardiac mortality risk. However, in population-based studies, QTcFri might be the one to be used by researchers. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-022-02502-2.
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Affiliation(s)
- Mohammad Hosein Yazdanpanah
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Ibn-Sina Square, P.O. Box: 74616-86688, Fasa, Fars, Iran.,Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Naghizadeh
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Ibn-Sina Square, P.O. Box: 74616-86688, Fasa, Fars, Iran
| | | | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Ibn-Sina Square, P.O. Box: 74616-86688, Fasa, Fars, Iran.
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10
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Zareei S, Behrasi F, Naghizadeh MM, Talebzadeh F, Kharmandar A, Davoodi SH, Asadi M, Farjam M, Homayounfar R. Oral contraceptive pill and metabolic syndrome: Fasa Persian Cohort Study (Descriptive study). Diabetes Metab Syndr 2022; 16:102408. [PMID: 35093686 DOI: 10.1016/j.dsx.2022.102408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS The contraceptive use is 56% and prevalence of metabolic syndrome (MetS) is 30% in Iran. The aim of this study investigates relationship between oral contraceptive pills (OCP) use and MetS in women in the cohort population of Fasa city. METHODS In a cross-sectional study, 5489 women aged 35-70 years were studied for 5 years in the Sheshdeh area in 2016. MetS were calculated using adult treatment panel III (ATP III) and international diabetes federation (IDF) methods. The odds ratio (OR) with a 95% confidence interval (CI) was reported. Linear regression was used to eliminate the confounding effect. RESULTS The OR of developing MetS in the OCP recipients was estimated as higher than the non-recipients. The OR of developing MetS using IDF criteria in OCP recipients was (OR = 0.896,95% CI:0.800-1.004). that increased to (OR = 1.230,95% CI:1.084-1.395) after adjusting for confounding variables. Also, the odds ratio using ATP (III) criteria was (OR = 0.900,95% CI:0.804-1.009). that increased to (OR = 1.245,95% CI:1.098-1.413) after adjusting for confounding variables. Also, the OR of developing MetS in OCP recipients decreased with increasing the number of MetS components from 1.199 to 0.812,95% CI:0.771-1.864,0.467-1.413, but after adjustment, increased from 1.151 to 1.747,95% CI:0.733-1.805,0.815-3.746. CONCLUSION The results of the present study showed that the OR of developing MetS in OCP recipients using both IDF and ATP (III) methods was higher after adjusting by confounder effects so it is recommended monitoring by physicians.
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Affiliation(s)
- Saeideh Zareei
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Fatemeh Behrasi
- Student's Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Fatemeh Talebzadeh
- Student's Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Kharmandar
- Student's Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Sayed Hosein Davoodi
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Reza Homayounfar
- National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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11
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Mirahmadizadeh A, Farjam M, Sharafi M, Fatemian H, Kazemi M, Geraylow KR, Dehghan A, Amiri Z, Afrashteh S. The relationship between demographic features, anthropometric parameters, sleep duration, and physical activity with ECG parameters in Fasa Persian cohort study. BMC Cardiovasc Disord 2021; 21:585. [PMID: 34876028 PMCID: PMC8650512 DOI: 10.1186/s12872-021-02394-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
Backgrounds Cardiovascular Diseases (CVDs) are the first leading cause of death worldwide. The present study aimed to investigate the relationship between demographics, anthropometrics, sleep duration, physical activity, and ECG parameters in the Fasa Persian cohort study. Methods In this cross-sectional study, the basic information of 10,000 participants aged 35–70 years in the Fasa cohort study was used. The data used in this study included demographic data, main Electrocardiogram (ECG) parameters, anthropometric data, sleep duration, and physical activity. Data analysis was performed using t-test, chi-square, and linear regression model. Results Based on multivariate linear regression analysis results, increased age was significantly associated with all study parameters. Nevertheless, gender and body mass index showed no significant relationship with SV3 and PR. Wrist circumference, hip circumference and waist circumference significantly increased the mean values of the ECG parameters. However, sleep duration was not significantly associated with the ECG parameters. In addition, hypertension was major comorbidity, which was shown to increase the mean values of the ECG parameters. Conclusion Several factors affected the ECG parameters. Thus, to interpret ECGs, in addition to age and gender, anthropometric indices, physical activity, and previous history of comorbidities, such as hypertension and ischemic heart disease, should be taken into consideration.
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Affiliation(s)
- Alireza Mirahmadizadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Farjam
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehdi Sharafi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hossein Fatemian
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Kazemi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Azizallah Dehghan
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Zahra Amiri
- Noncommunicable Diseases Research Center, Hormozgan University of Medical Sciences, Hormozgan, Iran
| | - Sima Afrashteh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
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12
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Targher G, Mantovani A, Grander C, Foco L, Motta B, Byrne CD, Pramstaller PP, Tilg H. Association between non-alcoholic fatty liver disease and impaired cardiac sympathetic/parasympathetic balance in subjects with and without type 2 diabetes-The Cooperative Health Research in South Tyrol (CHRIS)-NAFLD sub-study. Nutr Metab Cardiovasc Dis 2021; 31:3464-3473. [PMID: 34627696 DOI: 10.1016/j.numecd.2021.08.037] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/27/2021] [Accepted: 08/16/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) is the leading cause of death in patients with non-alcoholic fatty liver disease (NAFLD), both with and without type 2 diabetes mellitus (T2DM). Cardiac autonomic dysfunction is a risk factor for CVD morbidity and mortality. The aim of this pilot study was to assess whether there is an association between NAFLD and impaired cardiac autonomic function. METHODS AND RESULTS Among the first 4979 participants from the Cooperative Health Research in South Tyrol (CHRIS) study, we randomly recruited 173 individuals with T2DM and 183 age- and sex-matched nondiabetic controls. Participants underwent ultrasonography and vibration-controlled transient elastography (Fibroscan®, Echosens) to assess hepatic steatosis and liver stiffness. The low-to-high-frequency (LF/HF) power ratio and other heart rate variability (HRV) measures were calculated from a 20-min resting electrocardiogram (ECG) to derive a measure of cardiac sympathetic/parasympathetic imbalance. Among the 356 individuals recruited for the study, 117 had NAFLD and T2DM, 56 had T2DM alone, 68 had NAFLD alone, and 115 subjects had neither condition. Individuals with T2DM and NAFLD (adjusted odds ratio [OR] 4.29, 95% confidence intervals [CI] 1.90-10.6) and individuals with NAFLD alone (adjusted OR 3.41, 95% CI 1.59-7.29), but not those with T2DM alone, had a substantially increased risk of having cardiac sympathetic/parasympathetic imbalance, compared with those without NAFLD and T2DM. Logistic regression models were adjusted for age, sex, body mass index (BMI), hypertension, dyslipidemia, insulin resistance, hemoglobin A1c (HbA1c), C-reactive protein (CRP), and Fibroscan®-measured liver stiffness. CONCLUSIONS NAFLD was associated with cardiac sympathetic/parasympathetic imbalance, regardless of the presence or absence of T2DM, liver stiffness, and other potential confounding factors.
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Affiliation(s)
- Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy.
| | - Alessandro Mantovani
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Christoph Grander
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
| | - Luisa Foco
- Institute for Biomedicine, Eurac Research (Affiliated to the University of Lübeck), Bolzano, Italy
| | - Benedetta Motta
- Institute for Biomedicine, Eurac Research (Affiliated to the University of Lübeck), Bolzano, Italy; Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Christopher D Byrne
- Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, UK; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, UK
| | - Peter P Pramstaller
- Institute for Biomedicine, Eurac Research (Affiliated to the University of Lübeck), Bolzano, Italy
| | - Herbert Tilg
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University Innsbruck, Innsbruck, Austria
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13
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Yazdanpanah MH, Bahramali E, Kazemi M, Firouzabadi N, Arasteh P, Homayounfar R, Shamloo AS, Farjam M. The Fasa Registry on Systolic Heart Failure (FaRSH): Feasibility Study and the First 5-year Reports. Galen Med J 2021; 10:e2111. [PMID: 35620276 PMCID: PMC9107350 DOI: 10.31661/gmj.v10i0.2111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/21/2021] [Accepted: 05/18/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The literature on patients with heart failure (HF) from the Middle East, besides a few existing registries, is scarce. We report, for the first time in our country, a hospital-based registry for systolic HF. MATERIALS AND METHODS This was a web-based registry on HF, conducted in Vali-Asr Hospital affiliated with Fasa University of Medical Sciences, Fasa, Iran. The goal of this registry was to define overall baseline clinical characteristics and natural history of hospitalized patients with systolic HF, to evaluate current management schema and implementation of practice guidelines, and to determine the correlation between genetic predisposition environmental effects, individuals' characteristics of health, lifestyle, morbidity, and mortality in relation with the effects of medication. RESULTS To date, 2378 individuals with a mean of age 67.08±13.07 years have been registered. Among which, 1381 (58.07%) patients were diagnosed with denovo HF. Most of the patients (60.1%) were male, and 8.9% had admissions during the past 30 days. The most common causes of HF were ischemic heart disease (86.5%) and hypertension (5.3%). Most patients had NYHA class one (44.3%) and three (20.4%). Overall, near 30% had diabetes and more than 38% had hyperlipidemia. Most individuals have been not a history of cigarette smoking (68.7%) or water-pipe smoking (96.9%). Also, 22.2% were current opium users, and 3.2% were previous opium users. CONCLUSION The findings of this registry could make a realistic view of HF as a chronic disease with a burden. Therefore, policymakers can design programs and guidelines to prevent disease and better survival and quality of life.
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Affiliation(s)
- Mohammad Hosein Yazdanpanah
- Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
- Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | - Ehsan Bahramali
- Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Digestive Disease Research Center, Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Kazemi
- Department of Community and Preventive Medicine, Fasa University of Medical Sciences, Fasa, Iran
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Negar Firouzabadi
- Department of Pharmacology and Toxicology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Arasteh
- Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Department of MPH, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Homayounfar
- Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Mojtaba Farjam
- Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran
- Mojtaba Farjam, Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Ibn-Sina Square, Fasa, Fars, Iran Telephone Number: +98-715-3314068 Email Address:
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14
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Different body parts' fat mass and corrected QT interval on the electrocardiogram: The Fasa PERSIAN Cohort Study. BMC Cardiovasc Disord 2021; 21:277. [PMID: 34090333 PMCID: PMC8178852 DOI: 10.1186/s12872-021-02095-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/01/2021] [Indexed: 11/15/2022] Open
Abstract
Background Previous studies suggested that obesity and fat mass are associated with QT interval prolongation, but the role of different body parts' fat mass is unclear. The associations between total and regional fat mass (FM) and corrected QT interval (QTc) were investigated for the first time in this study.
Methods In this sub-analysis of Fasa PERSIAN cohort Study data, 3217 subjects aged 35–70 entered our study. Body fat mass was assessed by bioelectrical impedance analysis and QTc interval calculated by the QT interval measured by Cardiax® software from ECGs and Bazett’s formula. Uni- and multi-variable linear and logistic regression was performed in IBM SPSS Statistics v23. Results In males, the fat mass to fat-free mass (FM/FFM) ratio in the trunk, arms, total body, and legs were significantly higher in the prolonged QTc group (QTc > 450 ms). Trunk (B = 0.148), total (B = 0.137), arms (B = 0.124), legs (B = 0.107) fat mass index (FMI) showed significant positive relationship with continuous QTc (P-value < 0.001). Also, just the fat-free mass index of legs had significant positive associations with QTc interval (P-value < 0.05). Surprisingly, in females, the mean of FM/FFM ratio in trunk and legs in the normal QTc group had higher values than the prolonged QTc group (QTc > 470 ms). Also, none of the body composition variables had a significant correlation with continuous QTc. Conclusion Our study suggested that FMI ratios in the trunk, total body, arms, and legs were positively associated with QTc interval in males, respectively, from a higher to a lower beta-coefficient. Such associations were not seen in females. Our study implies that body fat mass may be an independent risk factor for higher QTc interval and, consequently, more cardiovascular events that should be investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02095-2.
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