Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome

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• dc.contributor.author Rosselló, Xavier
• dc.contributor.author Ramallal, Raúl
• dc.contributor.author Romaguera Bosch, Dora
• dc.contributor.author Alonso-Gómez, Ángel
• dc.contributor.author Alonso, Álvaro
• dc.contributor.author Tojal Sierra, Lucas
• dc.contributor.author Fernández Palomeque, Carlos
• dc.contributor.author Martínez-González, Miguel Ángel, 1957-
• dc.contributor.author Garrido Uriarte, María
• dc.contributor.author López Rodríguez, Luis
• dc.contributor.author Díaz Dorronsoro, Agnes
• dc.contributor.author Zaldua Irastorza, Olatz
• dc.contributor.author Shah, Amit J.
• dc.contributor.author Salas Salvadó, Jordi
• dc.contributor.author Fitó Colomer, Montserrat
• dc.contributor.author Toledo, Estefania
• dc.date.accessioned 2024-10-14T06:28:09Z
• dc.date.available 2024-10-14T06:28:09Z
• dc.date.issued 2024
• dc.description.abstract Aims: To 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 results: Participants 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. Conclusion: In overweight or obese people with Mets, an ILI had no impact on the underlying structural and functional LA substrate measurements associated with AF risk.
• dc.description.sponsorship The research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under award numbers R01HL137338 and K24HL148521. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was supported by the official Spanish Institutions for funding scientific biomedical research, Centro de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición (CIBEROBN), and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigación para la Salud (FIS), which is co-funded by the European Regional Development Fund (six co-ordinated FIS projects, including the following projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, and PI20/01158); the Especial Action Project entitled: Implementación y evaluación de una intervención intensiva sobre la actividad física Cohorte PREDIMED-Plus grant to J.S.-S.; the European Research Council (Advanced Research Grant 2014–19; agreement #340918) granted to M.Á.M.-G.; the Recercaixa (La Caixa Foundation) (number 2013ACUP00194) grant to J.S.-S.; grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, and PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; and the SEMERGEN grant. None of the funding sources were involved in the project design, in the collection, analysis, and interpretation of the data, in the writing of the report, or in the decision to submit the manuscript for publication.
• dc.format.mimetype application/pdf
• dc.identifier.citation Rossello X, Ramallal R, Romaguera D, Alonso-Gómez ÁM, Alonso A, Tojal-Sierra L, et al. Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome. Eur J Prev Cardiol. 2024 Mar 27;31(5):629-39. DOI: 10.1093/eurjpc/zwad380
• dc.identifier.doi http://dx.doi.org/10.1093/eurjpc/zwad380
• dc.identifier.issn 2047-4873
• dc.identifier.uri http://hdl.handle.net/10230/61383
• dc.language.iso eng
• dc.publisher Oxford University Press
• dc.relation.ispartof Eur J Prev Cardiol. 2024 Mar 27;31(5):629-39
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/340918
• dc.rights © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Atrial fibrillation
• dc.subject.keyword Intensive lifestyle intervention
• dc.subject.keyword Mediterranean diet
• dc.subject.keyword Metabolic syndrome
• dc.subject.keyword Obesity
• dc.title Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion