Tina E Brinkley1, Andrea Anderson2, Elsayed Z Soliman3, Alain G Bertoni3, Frank Greenway4, William C Knowler5, Stephen P Glasser6, Edward S Horton7, Mark A Espeland2. 1. Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 2. Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 3. Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. 4. Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana, USA. 5. Diabetes Epidemiology and Clinical Research Section, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA. 6. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 7. Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
BACKGROUND:Left ventricular hypertrophy assessed by electrocardiography (ECG-LVH) is a marker of subclinical cardiac damage and a strong predictor of cardiovascular disease (CVD) events. The prevalence of ECG-LVH is increased in obesity and type 2 diabetes; however, there are no data on the long-term effects of weight loss on ECG-LVH. The purpose of this study was to determine whether an intensive lifestyle intervention (ILI) reduces ECG-LVH in overweight and obese adults with type 2 diabetes. METHODS: Data from 4,790 Look AHEAD participants (mean age: 58.8 ± 6.8 years, 63.2% White) who were randomized to a 10-year ILI (n = 2,406) or diabetes support and education (DSE, n = 2,384) were included. ECG-LVH defined by Cornell voltage criteria was assessed every 2 years. Longitudinal logistic regression analysis with generalized estimation equations and linear mixed models were used to compare the prevalence of ECG-LVH and changes in absolute Cornell voltage over time between intervention groups, with tests of interactions by sex, race/ethnicity, and baseline CVD status. RESULTS: The prevalence of ECG-LVH at baseline was 5.2% in the DSE group and 5.0% in the ILI group (P = 0.74). Over a median 9.5 years of follow-up, prevalent ECG-LVH increased similarly in both groups (odds ratio: 1.02, 95% confidence interval: 0.83-1.25; group × time interaction, P = 0.49). Increases in Cornell voltage during follow-up were also similar between intervention groups (group × time interaction, P = 0.57). Intervention effects were generally similar between subgroups of interest. CONCLUSIONS: The Look AHEAD long-term lifestyle intervention does not significantly lower ECG-LVH in overweight and obese adults with type 2 diabetes. CLINICAL TRIALS REGISTRATION: Trial Number NCT00017953 (ClinicalTrials.gov).
RCT Entities:
BACKGROUND:Left ventricular hypertrophy assessed by electrocardiography (ECG-LVH) is a marker of subclinical cardiac damage and a strong predictor of cardiovascular disease (CVD) events. The prevalence of ECG-LVH is increased in obesity and type 2 diabetes; however, there are no data on the long-term effects of weight loss on ECG-LVH. The purpose of this study was to determine whether an intensive lifestyle intervention (ILI) reduces ECG-LVH in overweight and obese adults with type 2 diabetes. METHODS: Data from 4,790 Look AHEAD participants (mean age: 58.8 ± 6.8 years, 63.2% White) who were randomized to a 10-year ILI (n = 2,406) or diabetes support and education (DSE, n = 2,384) were included. ECG-LVH defined by Cornell voltage criteria was assessed every 2 years. Longitudinal logistic regression analysis with generalized estimation equations and linear mixed models were used to compare the prevalence of ECG-LVH and changes in absolute Cornell voltage over time between intervention groups, with tests of interactions by sex, race/ethnicity, and baseline CVD status. RESULTS: The prevalence of ECG-LVH at baseline was 5.2% in the DSE group and 5.0% in the ILI group (P = 0.74). Over a median 9.5 years of follow-up, prevalent ECG-LVH increased similarly in both groups (odds ratio: 1.02, 95% confidence interval: 0.83-1.25; group × time interaction, P = 0.49). Increases in Cornell voltage during follow-up were also similar between intervention groups (group × time interaction, P = 0.57). Intervention effects were generally similar between subgroups of interest. CONCLUSIONS: The Look AHEAD long-term lifestyle intervention does not significantly lower ECG-LVH in overweight and obese adults with type 2 diabetes. CLINICAL TRIALS REGISTRATION: Trial Number NCT00017953 (ClinicalTrials.gov).
Authors: P Verdecchia; G Schillaci; C Borgioni; A Ciucci; R Gattobigio; I Zampi; C Porcellati Journal: J Am Coll Cardiol Date: 1998-02 Impact factor: 24.094
Authors: Aditya Jain; Harikrishna Tandri; Darshan Dalal; Harjit Chahal; Elsayed Z Soliman; Ronald J Prineas; Aaron R Folsom; João A C Lima; David A Bluemke Journal: Am Heart J Date: 2010-04 Impact factor: 4.749
Authors: Kimmo Porthan; Teemu J Niiranen; Juha Varis; Ilkka Kantola; Hannu Karanko; Mika Kähönen; Markku S Nieminen; Veikko Salomaa; Heikki V Huikuri; Antti M Jula Journal: J Hypertens Date: 2015-06 Impact factor: 4.844
Authors: Lisa de las Fuentes; Alan D Waggoner; B Selma Mohammed; Richard I Stein; Bernard V Miller; Gary D Foster; Holly R Wyatt; Samuel Klein; Victor G Davila-Roman Journal: J Am Coll Cardiol Date: 2009-12-15 Impact factor: 24.094
Authors: Sebastiaan Hammer; Marieke Snel; Hildo J Lamb; Ingrid M Jazet; Rutger W van der Meer; Hanno Pijl; Edo A Meinders; Johannes A Romijn; Albert de Roos; Johannes W A Smit Journal: J Am Coll Cardiol Date: 2008-09-16 Impact factor: 24.094
Authors: Donna H Ryan; Mark A Espeland; Gary D Foster; Steven M Haffner; Van S Hubbard; Karen C Johnson; Steven E Kahn; William C Knowler; Susan Z Yanovski Journal: Control Clin Trials Date: 2003-10
Authors: Peter M Okin; Richard B Devereux; Sverker Jern; Sverre E Kjeldsen; Stevo Julius; Markku S Nieminen; Steven Snapinn; Katherine E Harris; Peter Aurup; Jonathan M Edelman; Hans Wedel; Lars H Lindholm; Björn Dahlöf Journal: JAMA Date: 2004-11-17 Impact factor: 56.272
Authors: Qingmiao Shao; Lei Meng; Gary Tse; Abhishek C Sawant; Calista Zhuo Yi Chan; George Bazoukis; Adrian Baranchuk; Guangping Li; Tong Liu Journal: Ann Noninvasive Electrocardiol Date: 2018-10-03 Impact factor: 1.468
Authors: Kathleen M Hayden; Rebecca H Neiberg; Joni K Evans; José A Luchsinger; Owen Carmichael; Gareth R Dutton; Karen C Johnson; Steven E Kahn; Stephen R Rapp; Sevil Yasar; Mark A Espeland Journal: Dement Geriatr Cogn Disord Date: 2021-08-19 Impact factor: 3.346