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September 17, 2026European Heart Journal OpenOpen Access

Cardiac Electro-structural Remodeling and Arrhythmia Risks Across the Spectrum of Obesity Defined by the New Lancet framework

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Why the study?

Does obesity defined by the new Lancet framework increase the risk of incident arrhythmias and cardiac remodeling compared to non-obesity?

Population

487,806 participants from the UK Biobank, stratified by obesity phenotypes using the new Lancet framework.

Comparison

Clinical obesity and preclinical obesity vs Non-obesity without organ dysfunction

Design

Cohort

Key result

Clinical obesity was associated with significantly increased risk for incident supraventricular, brady-, and ventricular arrhythmias compared to non-obesity (FDR-corrected P<0.05).

Authors

NZNan ZhangJZJinhua ZhaoYGYubing Guo

Discussion

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Overview

May warrant arrhythmia monitoring in obesity; extends risk associations across stages but requires prospective validation.

Key Points

  • To evaluate cardiac electro-structural remodeling and incident arrhythmia risks across obesity categories defined by the new Lancet Commission framework.
  • Stratified N=487,806 participants from the UK Biobank into non-obesity, preclinical obesity, and clinical obesity using five anthropometric measures, ICD-10 codes, laboratory values, and self-reported organ dysfunction.
  • Tracked co-primary outcomes of incident supraventricular, brady-, and ventricular arrhythmias along with secondary component endpoints, electrocardiographic parameters, and structural remodeling metrics.
  • Clinical obesity affected 44.7% of participants and was associated with significantly elevated risks for all primary and secondary arrhythmia outcomes (all FDR-corrected P < 0.05) and arrhythmia recurrence compared to non-obesity.
  • Preclinical obesity (18.7% of participants) was associated with significantly increased risk of supraventricular arrhythmia and bradyarrhythmia, but not ventricular arrhythmia or arrhythmia recurrence.
  • Clinical obesity demonstrated marked ECG changes (including prolonged P-wave, PR, QTc, and QRS durations) and structural remodeling (enlarged left atrial volume and concentric left ventricular remodeling), whereas incremental prognostic gain of the Lancet framework over BMI was small and outcome-dependent.

Study Design

Type

Cohort (n=487,806)

Structured PICO

Does obesity defined by the new Lancet framework increase the risk of incident arrhythmias and cardiac remodeling compared to non-obesity?

P
Population
487,806 individuals from the UK Biobank stratified by the Lancet obesity framework to assess incident arrhythmia risks.
E
Exposure
Clinical obesity and preclinical obesity (exposure)
C
Comparator
Non-obesity without organ dysfunction
O
Outcome
Incident supraventricular, brady-, or ventricular arrhythmias (co-primary outcomes)hard clinical

Main Result

p-value: p=<0.05

The new Lancet obesity framework reveals a gradient of arrhythmic and structural remodeling risk across obesity stages, highlighting the need for early monitoring in preclinical obesity.

Cite This Study

Zhang et al. (2026) conducted a cohort in Obesity and Arrhythmia (n=487,806). Clinical and preclinical obesity vs. Non-obesity without organ dysfunction was evaluated on Incident supraventricular, brady-, or ventricular arrhythmias (p=<0.05). Clinical obesity was associated with significantly increased risk for incident supraventricular, brady-, and ventricular arrhythmias compared to non-obesity (FDR-corrected P<0.05).

synapsesocial.com/papers/6aabb6635f706d05830e4d20https://doi.org/10.1093/ehjopen/oeag151
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