Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome.
Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome.
复制标题
强化生活方式干预对代谢综合征患者心房颤动结构和功能基础的影响。
DOI：
10.1101/2023.08.02.23293550
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Shah,A
中科院分区：
文献类型：
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作者：
Rossello,Xavier;Ramallal,Raúl;Romaguera,Dora;Alonso-Gómez,ÁngelM;Alonso,Alvaro;Tojal-Sierra,Lucas;Fernández-Palomeque,Carlos;Martínez-González,MiguelÁngel;Garrido-Uriarte,María;López,Luis;Díaz,Agnes;Zaldua-Irastorza,Olatz;Shah,A
目的评价强化生活方式干预（ILI）对超重或肥胖代谢综合征（Mets）患者心房颤动（AF）结构和功能的影响。方法和结果PREvención con DIeta MEDiterranea-Plus试验的参与者（n= 6874）以1:1的比例随机分配到基于能量降低的地中海饮食、增加身体活动和认知行为体重管理的ILI计划或低强度饮食建议的对照干预。核心超声心动图实验室在基线、3年和5年随访期间评估了534名参与者的左心房（LA）应变、功能和容量。采用混合模型评价ILI对LA结构和功能的影响。在子样本中，基线平均年龄为65岁[标准差（SD） 5岁]，40%的参与者是女性。5年后，ILI组的平均体重变化为- 3.9 kg (SD 5.3 kg)，对照组为- 0.3 kg （SD 5.1 kg）。在5年的时间里，两组都经历了LA结构和功能的恶化，随着时间的推移，LA体积和刚度指数增加，LA纵向应变、LA功能指数和LA排空率降低。ILI组和对照组的任何主要结局变化均无显著差异[对照组LA排空分数：- 0.95%[95%可信区间(CI) - 0.93, - 0.98]， ILI组LA排空分数：- 0.97% [95% CI - 0.94, - 1.00]，组间p = 0.80；LA纵向应变：对照组为0.82% [95% CI 0.79, 0.85]， ILI组为0.85% [95% CI 0.82, 0.89]，组间p = 0.24}或任何次要结果。结论：在超重或肥胖的met患者中，ILI对与房颤风险相关的潜在结构和功能LA底物测量没有影响。
AimsTo evaluate the effect of an intensive lifestyle intervention (ILI) on the structural and functional cardiac substrate of atrial fibrillation (AF) in overweight or obese people with metabolic syndrome (Mets).Methods and resultsParticipants of the PREvención con DIeta MEDiterranea-Plus trial (n= 6874) were randomized 1:1 to an ILI programme based on an energy-reduced Mediterranean diet, increased physical activity, and cognitive-behavioural weight management or to a control intervention of low-intensity dietary advice. A core echocardiography lab evaluated left atrial (LA) strain, function, and volumes in 534 participants at baseline, 3-year, and 5-year follow-ups. Mixed models were used to evaluate the effect of the ILI on LA structure and function. In the subsample, the baseline mean age was 65 years [standard deviation (SD) 5 years], and 40% of the participants were women. The mean weight change after 5 years was −3.9 kg (SD 5.3 kg) in the ILI group and −0.3 kg (SD 5.1 kg) in the control group. Over the 5-year period, both groups experienced a worsening of LA structure and function, with increases in LA volumes and stiffness index and decreases in LA longitudinal strain, LA function index, and LA emptying fraction over time. Changes in the ILI and control groups were not significantly different for any of the primary outcomes {LA emptying fraction: −0.95% [95% confidence interval (CI) −0.93, −0.98] in the control group, −0.97% [95% CI −0.94, −1.00] in the ILI group,Pbetween groups= 0.80; LA longitudinal strain: 0.82% [95% CI 0.79, 0.85] in the control group, 0.85% [95% CI 0.82, 0.89] in the ILI group,Pbetween groups= 0.24} or any of the secondary outcomes.ConclusionIn overweight or obese people with Mets, an ILI had no impact on the underlying structural and functional LA substrate measurements associated with AF risk.