Subclinical Ventricular Electrical Remodeling In Young Adults With Adiposity: A Cross Sectional Analysis Of The Ventricular Activation Time

Abstract

Background: Obesity has become more common in recent years, especially in young adults. Obesity is known to increase cardiovascular risk, but the early subclinical effects on cardiac electrical activity in healthy young individuals are not well understood. This study examined Ventricular Activation Time (VAT) – a novel ECG marker – and its association with general obesity (BMI) and central adiposity (WHR) in healthy young adults.

Methods: We carried out this cross‑sectional community‑based study in a small South Indian town over 5 months on healthy young adults (n=150, 18‑30 years) and divided them equally into three groups (n=50 each) according to Asia‑Pacific BMI criteria: normal weight (18.5‑22.9 kg/m²), overweight (23‑24.9 kg/m²), and obese (≥25 kg/m²). All three groups were matched for age and sex. VAT was measured from Lead II of a standard 12‑lead ECG. BMI and WHR were recorded. Data were analyzed using ANOVA, Pearson’s correlation, and Tukey’s post‑hoc test.

Results: VAT increased progressively with higher BMI. Normal weight, overweight, and obese groups had mean VAT values of 36.78±3.00 ms, 37.54±3.05 ms, and 41.22±3.09 ms, respectively (F =  30.21, p < 0.001). The obese group had significantly longer VAT than both normal weight and overweight groups (p < 0.001 for each), while no difference was observed between normal weight and overweight groups (p =  0.42). Both BMI (r =  0.464, p < 0.001) and WHR (r =  0.324, p < 0.001) showed significant positive correlations with VAT.

Conclusion: Even in healthy young adults, obesity is associated with early changes in ventricular electrical activity detected by VAT. Both overall adiposity and central obesity contribute to this effect. VAT is a low‑cost, non‑invasive ECG parameter that may serve as an early screening tool to identify obese young individuals at risk and to motivate weight management.