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Effect of body weight reduction on cardiac remodeling indicators and atrial fibrillation recurrence in obese patients

Authors: Bogdanov A.R.1 2, Romanova T.A.3, Fedulaev Yu.N.2

Company: 1 Russian National Research Medical University named after N.I. Pirogov, Moscow, Russian Federation
2 City Clinical Hospital № 1 named after N.I. Pirogov, Moscow, Russian Federation
3 City Clinical Hospital named after V.P. Demikhov, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2025-19-2-229-240

For citation: Bogdanov A.R., Romanova T.A., Fedulaev Yu.N. Effect of body weight reduction on cardiac remodeling indicators and atrial fibrillation recurrence in obese patients. Creative Cardiology. 2025; 19 (2): 229–240 (in Russ.). DOI: 10.24022/1997-3187-2025- 19-2-229-240

Received / Accepted:  17.03.2025 / 07.04.2025

Keywords: atrial fibrillation obesity cardiac remodeling



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Abstract

Objective. To evaluate the effect of body weight (BW) reduction against the background of personalized diet therapy (DT) on cardiac remodeling indices, the frequency of atrial fibrillation (AF) paroxysms, hospitalizations due to AF and cardiovascular events (CVE) in patients with obesity.

Material and methods. A randomized, controlled, prospective cohort study included 100 patients with grade III obesity and paroxysmal AF, divided into 2 groups of 50 patients. The main group (MG) received a hypocaloric diet, the control group (CG) – a eucaloric diet. After 3 and 6 months, the dynamics of bioimedansometry parameters, blood pressure (BP), echocardiography, frequency of AF paroxysms, hospitalizations due to AF, CVE (acute myocardial infarction, acute cerebrovascular insufficiency) and mortality due to cardiovascular causes were assessed.

Results. In the MG, over 6 months of DT, a decrease in BM was achieved in men by 16.5% (p < 0.001), in women – by 16.8% (p < 0.001). The following was revealed: a decrease in the left ventricular end-diastolic dimension (LVEDD) by 18.8% (p<0.01), left ventricular end-systolic dimension (LVED) by 16.9% (p<0.005), end-diastolic volume (EDV) index by 18.6% (p<0.01), end-systolic volume (ESV) index by 16.6% (p<0.005), effective mitral regurgitation area (EROA) by 35.8% (p<0.001), left atrial anterior-posterior dimension (LAA) by 11.93% (p<0.005), left atrial (LA) volume index by 19.3% (p<0.001), and pulmonary artery systolic pressure (PASP) by 25.7% (p<0.001). The proportion of patients with E>A increased from 12.6% to 24.9% (p=0.03); the E/e’ ratio decreased from 13.4 to 10.1 units (p=0.034). The frequency of AF paroxysms decreased by 52.2%, hospitalizations by 44.6%, and CVS by 33.3%.

Conclusion. DT aimed at reducing BW in individuals with AF and obesity allows for reverse cardiac remodeling, a decrease in the frequency of AF recurrences, hospitalizations, and CVE.

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About Authors

  • Alfred R. Bogdanov, Dr. Med. Sci., Professor, Deputy Chief Physician for Therapeutic Care; ORCID
  • Tatyana A. Romanova, Cardiologist; ORCID
  • Yuriy N. Fedulaev, Dr. Med. Sci., Professor, Head of the Department of Faculty Therapy; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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