CLINICAL AND INSTRUMENTAL FEATURES OF AUTONOMIC DYSFUNCTION AND SILENT ARRHYTHMIAS IN OBESE WOMEN

Abstract

This study investigates clinical and instrumental features of autonomic nervous system function and the prevalence of silent arrhythmias in obese women. A cross-sectional, case-control study included 84 women aged 25–65 years: 42 with obesity (BMI ≥30 kg/m²) and 42 controls (BMI 18.5–24.9 kg/m²). All participants underwent 24-hour Holter ECG monitoring, heart rate variability (HRV) analysis, a 6-minute walk test, and measurement of serum NT-proBNP and high-sensitivity C-reactive protein (hs-CRP). Results showed reduced vagal activity (SDNN 89.4±21.6 ms vs. 128.3±24.1 ms; p<0.001), a shift of sympathovagal balance toward sympathetic predominance (LF/HF 2.86±0.74 vs. 1.42±0.51; p<0.001), and a higher frequency of silent ventricular extrasystoles (9.8±6.2 vs. 3.1±2.4; p=0.002) in the obesity group. The 6-minute walk distance was significantly shorter (418.6±52.3 m vs. 512.4±46.8 m; p<0.001). Correlation analysis revealed positive associations of the LF/HF ratio with hs-CRP (r=0.49; p=0.007) and HOMA-IR (r=0.52; p=0.004). In conclusion, obesity promotes autonomic imbalance and silent arrhythmias in women; Holter monitoring and HRV analysis are effective tools for early instrumental screening in this patient category.