(Press-News.org) SAN DIEGO (March 16, 2015) -- Obese patients with atrial fibrillation who lost at least 10 percent of their body weight were six times more likely to achieve long-term freedom from this common heart rhythm disorder compared to those who did not lose weight, according to a study presented at the American College of Cardiology's 64th Annual Scientific Session.
The study is the first to track the long-term effects of weight loss and the degree of weight fluctuation on atrial fibrillation burden. Patients who lost more weight and maintained a more stable weight over four years showed marked reductions in atrial fibrillation burden and severity, the study's primary endpoints.
"Previous studies have shown that weight management can reduce atrial fibrillation symptoms in the short term and improve outcomes of ablation [a surgical treatment for atrial fibrillation]," said Rajeev Pathak, M.D., a cardiologist and electrophysiology fellow at the University of Adelaide, Adelaide, Australia and the study's lead author. "We sought to shed light on the long-term outcomes of sustained weight loss, the effects of the amount of weight lost and the impact of changes in weight over time."
An estimated 5.6 million U.S. adults have atrial fibrillation, which can cause episodes of weakness, shortness of breath and palpitations and increases the risk of more serious problems such as stroke. Obesity, seen in more than one-third of U.S. adults, is associated with an increased risk of atrial fibrillation.
"We found that sustained weight loss is achievable in obese patients and that it can significantly reduce the burden of atrial fibrillation," Pathak said. "Weight loss also led to favorable changes in cardiovascular risk factors such as high blood pressure, obstructive sleep apnea and diabetes, along with improvements in the structure and function of the heart."
Researchers enrolled 355 participants in a dedicated weight loss clinic and tracked their health annually for an average of four years. All participants were obese and had atrial fibrillation at the start of the study. To encourage weight loss, the clinic used a motivational, goal-directed approach that included three in-person visits per month, detailed dietary guidance, low-intensity exercise, support counseling and maintenance of a daily diet and physical activity diary.
Participants returned to the clinic annually for a health exam and atrial fibrillation monitoring. To assess the frequency, duration and severity of symptoms, patients completed questionnaires and wore a Holter monitor, a machine that tracks the heart's rhythms, for seven days. An echocardiogram, a sonogram of the heart, was also conducted to assess measures of heart health including the volume of the left atrium and the thickness of the left ventricular wall.
After an average of four years, 45 percent of patients who lost 10 percent or more of their body weight and 22 percent of patients who lost 3 to 9 percent of their weight achieved freedom from atrial fibrillation symptoms without the use of any atrial fibrillation surgery or medication. Only 13 percent of patients who lost less than 3 percent of their body weight were free of symptoms without these treatments. Even with the use of surgery or medication, those who lost more weight were substantially more likely to achieve freedom from atrial fibrillation symptoms.
Sustained weight management and a linear weight loss trajectory were also associated with greater freedom from atrial fibrillation. Patients who lost and then regained weight, causing a fluctuation of more than 5 percent between annual visits, were twice as likely to have recurrent rhythm problems than those who did not experience such fluctuations.
Weight loss was also associated with significant beneficial structural changes in the heart and significantly improved other markers of heart health including blood pressure, cholesterol and blood sugar levels. In an analysis that took all of these factors into account, patients who lost at least 10 percent of their weight were six times more likely to achieve freedom from atrial fibrillation than patients who lost less than 3 percent of their weight or gained weight.
Patients with permanent atrial fibrillation, a previous ablation or a severe medical illness were excluded from participating in the study. While the researchers used standardized procedures and follow up to reduce bias in the patient selection and evaluation process, all patients voluntarily opted to participate in the weight loss program and this may contribute to some level of bias, Pathak said. Future studies that involve a more diverse patient population could help to further refine understanding of the relationships between obesity and atrial fibrillation.
INFORMATION:
This study was simultaneously published online in the Journal of the American College of Cardiology at the time of presentation.
The ACC's Annual Scientific Session brings together cardiologists and cardiovascular specialists from around the world each year to share the newest discoveries in treatment and prevention. Follow @ACCMediaCenter and #ACC15 for the latest news from the meeting.
The American College of Cardiology is a 49,000-member medical society that is the professional home for the entire cardiovascular care team. The mission of the College is to transform cardiovascular care and to improve heart health. The ACC leads in the formation of health policy, standards and guidelines. The College operates national registries to measure and improve care, provides professional medical education, disseminates cardiovascular research and bestows credentials upon cardiovascular specialists who meet stringent qualifications. For more information, visit acc.org.
DURHAM, N.C. -- When March Madness kicks off this week, you might expect the bleachers to be filled with alumni and students from the competing colleges. In fact, only about a third of die-hard college sports fans are alumni of their teams' universities, and another third never attended college at all, according to a new Duke University study.
The new research by Charles Clotfelter, a professor of public policy, economics and law at Duke's Sanford School of Public Policy, draws upon an unusual source for its conclusions: obituaries.
Clotfelter's article, "Die-Hard ...
CHAMPAIGN, Ill. -- Subsistence farmers in Africa, the Americas and the Caribbean are learning how to construct raised planting beds and install drip irrigation systems to boost their agricultural productivity, conserve water and perhaps even halt the rapid advance of desertification in some drought-prone regions.
This educational effort, led in large part by nonprofit groups and private donors, is getting a boost from Scientific Animations Without Borders, an initiative that produces animated educational videos that can be played and shared on cellphones and other digital ...
Commitment to well being of others difficult to sustain over long run
Personal redemption narrative sustains motivation to engage in prosocial behavior
African-Americans more likely to be motivated by stories of personal redemption
Redemptive stories sustain hope that sacrifices today may produce future dividends
EVANSTON, Ill. --- Middle-aged Americans who show high levels of societal involvement and positive mental health are especially likely to construe their lives as stories of personal redemption, according to new Northwestern University research.
Previous ...
A review of clinical trial data suggests vitamin D supplementation was ineffective at lowering blood pressure (BP) and should not be used as an antihypertensive, according to an article published online by JAMA Internal Medicine.
Intervention studies have produced conflicting evidence on the BP-lowering effect of vitamin D. An increasing number of clinical trials of have studied vitamin D and cardiovascular health, according to the study background.
Miles D. Witham, B.M., B.Ch., Ph.D., of the University of Dundee, Scotland, and coauthors analyzed clinical trial data ...
An analysis of publicly available outbreak data suggests that substandard vaccination compliance is likely to blame for the recent measles outbreak linked to Disneyland in California, according to an article published online by JAMA Pediatrics.
Without vaccination, measles is highly contagious. The recent outbreak started in December 2014, although the index case has not yet been identified. The rapid growth of cases indicates that a substantial percentage of the exposed population may be susceptible to measles infection due to lack of, or incomplete, vaccination, according ...
A study of brain aging finds that being male was associated with worse memory and lower hippocampal volume in individuals who were cognitively normal at baseline, while the gene APOE ?4, a risk factor for Alzheimer disease, was not, according to an article published online by JAMA Neurology.
Typical cognitive aging may be defined as age-associated changes in cognitive performance in individuals free of dementia. To assess brain imaging findings associated with typical aging, the full adult age spectrum should be included, according to the study background.
Clifford ...
Inadequate vaccine coverage is likely a driving force behind the ongoing Disneyland measles outbreak, according to calculations by a research team at Boston Children's Hospital. Their report, based on epidemiological data and published online by JAMA Pediatrics, indicates that vaccine coverage among the exposed populations is far below that necessary to keep the virus in check, and is the first to positively link measles vaccination rates and the ongoing outbreak.
By examining case numbers reported by the California Department of Public Health and current and historical ...
There are only five bodies in our solar system that are known to bear rings. The most obvious is the planet Saturn; to a lesser extent, rings of gas and dust also encircle Jupiter, Uranus, and Neptune. The fifth member of this haloed group is Chariklo, one of a class of minor planets called centaurs: small, rocky bodies that possess qualities of both asteroids and comets.
Scientists only recently detected Chariklo's ring system -- a surprising finding, as it had been thought that centaurs are relatively dormant. Now scientists at MIT and elsewhere have detected a possible ...
March 16, 2015 - As more women veterans seek health care in the Veterans Administration (VA) system, effective approaches are needed to ensure that their unique needs are recognized and met. A special April supplement to Medical Care collects new studies from an ongoing research initiative to inform health care policy for women veterans. The journal is published by Wolters Kluwer.
"The goal of this supplement is to disseminate new research findings related to the planning, organization, financing, provision, evaluation and improvement of health services and/or outcomes ...
URBANA - University of Illinois scientists have engineered a "jailbreaking" yeast that could greatly increase the health benefits of wine while reducing the toxic byproducts that cause your morning-after headache.
"Fermented foods--such as beer, wine, and bread--are made with polyploid strains of yeast, which means they contain multiple copies of genes in the genome. Until now, it's been very difficult to do genetic engineering in polyploid strains because if you altered a gene in one copy of the genome, an unaltered copy would correct the one that had been changed," ...
