The interplay of heart rate variability and ventricular repolarization parameters in the obese state: a review

The impact of obesity on heart rate variability (HRV) and ventricular repolarization, both vital indicators of cardiovascular health, is the focus of this review. Obesity, measured by BMI, waist circumference, and waist-to-hip ratio, significantly increases cardiovascular disease (CVD) risk due to structural and autonomic heart changes. Findings show that obese individuals exhibit prolonged QT and Tpeak-to-Tend (Tpe) intervals, suggesting delayed ventricular recovery and greater arrhythmia risk. Additionally, obesity-induced autonomic imbalance favors sympathetic activity over parasympathetic, reducing HRV and raising arrhythmogenic potential. Elevated QT and Tpe intervals reflect extended cardiac recovery phases, which contribute to poor cardiac outcomes. The Tpe interval could serve as an early marker of cardiac dysfunction in obese populations, highlighting the importance of early intervention to reduce CVD risk and enhance treatment strategies for obesity-related cardiovascular changes.