The relationship between neck circumference and atrial electrical remodeling in obesity-related hypertension patients

Objective: To investigate the relationship between neck circumference(NC) and cardiac electrical remodeling in obesity-related hypertension patients. Methods: The 479 patients were included. Anthropometric parameters, electrocardiogram parameters and other clinical information were collected. Atrial electrical remodeling included increased heterogeneity of atrial electrical activity[defined as P wave dispersion(Pwd)>80ms] and inter-atrial conduction block[defined as maximum P wave duration(Pmax)>120ms]. Increased transmural dispersion of ventricular repolarization(TDR) was defined as Tpe>100ms and Tpe/QT>0.3. The correlation between NC and electrical remodeling was discussed using restricted cubic splines, logistic regression analysis and subgroup analysis. Receiver operating characteristic curve(ROC) was used to investigate whether NC can identify atrial electrical remodeling. Results: In terms of atrial electrical remodeling, NC was independently related with increased heterogeneity of atrial electrical activity(OR=1.19, 95%CI1.01-1.40, P=0.044) and atrial conduction block(OR=1.23, 95%CI1.10-1.38, P<0.001) after adjusting for confounding factors, and the risks increased linearly. Subgroup analysis illustrated NC elevated more risk of atrial electrical remodeling in male patients with snoring. ROC curve showed NC could recognize atrial electrical remodeling. As for ventricular electrical remodeling, the correlation between NC and traditional repolarization parameters(QT interval, QTc), QRS related voltage parameters which reflect ventricular hypertrophy and QRS duration reflecting abnormal ventricular depolarization were not significant. NC was only correlated with Tpe and Tpe/QT, reflecting increased TDR. Conclusion: High NC is an independent risk factor for atrial electrical remodeling in obesity-related hypertension patients, especially in male and snoring patients.