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Published in: Obesity Surgery 11/2011

01-11-2011 | Clinical Research

Morphofunctional Evaluation of the Heart of Obese Patients Before and After Bariatric Surgery

Authors: Antonio Carlos Valezi, Vitor Hugo Soares Machado

Published in: Obesity Surgery | Issue 11/2011

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Abstract

Background

This study aims to evaluate the effect of weight loss on the physical capacity and the structure and function of the heart after bariatric surgery.

Methods

Forty-three adult obese patients, 31 women (72.1%) and 12 men (27.9%), were submitted to electrocardiogram, ergometric test, and echo Doppler cardiogram at presurgical stage and 1 year after Roux-en-Y gastric bypass. The statistical analysis utilized the Wilcoxon, Student’s t, and Shapiro–Wilk tests with 5% significance level.

Results

Weight was reduced from 116.5 ± 21.5 to 80 ± 15.9 kg and body mass index from 41.8 ± 4.4 to 28.4 ± 3.8 kg/m2. Cardiac frequency was reduced from 77.9 ± 9.6 to 70.9 ± 7.8 bpm, systolic pressure from 130 ± 20 to 120 ± 10 mmHg, and diastolic pressure from 80 ± 10 to 80 ± 0 mmHg. Ergometric tests showed distance covered from 378.9 ± 126.5 to 595 ± 140.4 m, metabolic coefficient from 6.7 ± 2.4 to 8.3 ± 2.6 ml O2/kg/min, and oxygen consumption (VO2) from 23.1 ± 8.4 to 30 ± 10.3 metabolic equivalents of task. The echo Doppler cardiogram showed interventricular septum from 12 ± 2 to 10 ± 1 mm, posterior wall from 11 ± 2 to 10 ± 1 mm, and ventricular mass from 273 ± 85 to 216 ± 60 g. There was improvement in the diastolic function with an increase in the E′/A′ and E/A relationship and the ejection fraction with an increase from 70.2 ± 7.2% to 72.9 ± 6.4%.

Conclusions

Bariatric surgery improved physical capacity as well as structural and functional improvement of the heart.
Literature
1.
go back to reference Von Eyben FE, Mouritsen E, Holm J, et al. Intra-abdominal obesity and metabolic risk factors: a study of young adults. Int J Obes Relat Metab Disord. 2003;27:941–9.CrossRef Von Eyben FE, Mouritsen E, Holm J, et al. Intra-abdominal obesity and metabolic risk factors: a study of young adults. Int J Obes Relat Metab Disord. 2003;27:941–9.CrossRef
2.
go back to reference Anderson JW, Konz EC. Obesity and disease management: effects of weight loss on comorbid conditions. Obes Res. 2001;9:326–34.CrossRef Anderson JW, Konz EC. Obesity and disease management: effects of weight loss on comorbid conditions. Obes Res. 2001;9:326–34.CrossRef
3.
go back to reference Schillaci G, Pasqualini L, Vaudo G, et al. Effect of body weight changes on 24-hour blood pressure and left ventricular mass hypertension: a 4 year follow up. Am J Hypertens. 2003;16:634–9.PubMedCrossRef Schillaci G, Pasqualini L, Vaudo G, et al. Effect of body weight changes on 24-hour blood pressure and left ventricular mass hypertension: a 4 year follow up. Am J Hypertens. 2003;16:634–9.PubMedCrossRef
4.
go back to reference Chiew YW et al. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation. 2004;110:3081–7.CrossRef Chiew YW et al. Alterations of left ventricular myocardial characteristics associated with obesity. Circulation. 2004;110:3081–7.CrossRef
5.
go back to reference Levy D, Savage DD, Garrinson RS. Echocardiography criteria for left ventricular hypertrophy. The Framinghan Heart Study. Am J Cardiol. 1987;59:956.PubMedCrossRef Levy D, Savage DD, Garrinson RS. Echocardiography criteria for left ventricular hypertrophy. The Framinghan Heart Study. Am J Cardiol. 1987;59:956.PubMedCrossRef
7.
go back to reference Masserli FH, Ventura HO, Reisin E. Borderline hypertension and obesity: two hypertensive states with elevated cardiac output. Circulation. 1982;66:55–60.CrossRef Masserli FH, Ventura HO, Reisin E. Borderline hypertension and obesity: two hypertensive states with elevated cardiac output. Circulation. 1982;66:55–60.CrossRef
8.
go back to reference Kavanagh T, Mertens DJ, Hamm LF, et al. Prediction of long-term prognosis in 12,169 men referred for cardiac rehabilitation. Circulation. 2002;106:666–71.PubMedCrossRef Kavanagh T, Mertens DJ, Hamm LF, et al. Prediction of long-term prognosis in 12,169 men referred for cardiac rehabilitation. Circulation. 2002;106:666–71.PubMedCrossRef
9.
go back to reference Faintuch J, Souza SAF, Valezi AC, et al. Pulmonary function and aerobic capacity in asymptomatic bariatric candidates with very severe morbid obesity. Rev Hosp Clin Fac Med Univ Sao Paulo. 2004;59:181–6. Faintuch J, Souza SAF, Valezi AC, et al. Pulmonary function and aerobic capacity in asymptomatic bariatric candidates with very severe morbid obesity. Rev Hosp Clin Fac Med Univ Sao Paulo. 2004;59:181–6.
10.
go back to reference Roger VL, Jacobsen SJ, Pellika PA, et al. Prognostic value of treadmill exercise testing: a population-based study in Omsted Country, Minnesota. Circulation. 1998;98:2836–41.PubMed Roger VL, Jacobsen SJ, Pellika PA, et al. Prognostic value of treadmill exercise testing: a population-based study in Omsted Country, Minnesota. Circulation. 1998;98:2836–41.PubMed
11.
go back to reference Kavanagh T, Mertens DJ, Hamm LF, et al. Peak oxygen consumption and cardiac mortality in women referred for cardiac rehabilitation. J Am Coll Cardiol. 2003;42:2139–43.PubMedCrossRef Kavanagh T, Mertens DJ, Hamm LF, et al. Peak oxygen consumption and cardiac mortality in women referred for cardiac rehabilitation. J Am Coll Cardiol. 2003;42:2139–43.PubMedCrossRef
12.
go back to reference Alpert MA, Lambert CR, Panayiotou H, et al. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol. 1995;76:1194–7.PubMedCrossRef Alpert MA, Lambert CR, Panayiotou H, et al. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol. 1995;76:1194–7.PubMedCrossRef
13.
go back to reference Duflou J, Virmani R, Rabin I, et al. Sudden death as a result of heart disease in morbid obesity. Am Heart J. 1995;130:306–13.PubMedCrossRef Duflou J, Virmani R, Rabin I, et al. Sudden death as a result of heart disease in morbid obesity. Am Heart J. 1995;130:306–13.PubMedCrossRef
14.
go back to reference Alpert MA, Terry BE, Kelly DL. Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol. 1985;55:783–6.PubMedCrossRef Alpert MA, Terry BE, Kelly DL. Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol. 1985;55:783–6.PubMedCrossRef
15.
go back to reference Cunha L, Cunha C. Estudo ecocardiográfico evolutivo das alterações anátomo-funcionais do coração em obesos submetidos à cirurgia bariátrica (Evolutive echocardiographic study of the anatomical and functional alterations in the hearts of obese patients submitted to bariatric surgery). Arq Bras Cardiol. 2006;87:615–22.PubMedCrossRef Cunha L, Cunha C. Estudo ecocardiográfico evolutivo das alterações anátomo-funcionais do coração em obesos submetidos à cirurgia bariátrica (Evolutive echocardiographic study of the anatomical and functional alterations in the hearts of obese patients submitted to bariatric surgery). Arq Bras Cardiol. 2006;87:615–22.PubMedCrossRef
16.
go back to reference Petrie MC, Caruna L, Beny C, et al. Diastolic heart failure or heart failure caused by subtle left ventricular systolic dysfunction? Heart. 2002;87:29–31.PubMedCrossRef Petrie MC, Caruna L, Beny C, et al. Diastolic heart failure or heart failure caused by subtle left ventricular systolic dysfunction? Heart. 2002;87:29–31.PubMedCrossRef
17.
go back to reference Brad A, Grossman W. Evaluation and management of diastolic heart failure. Circulation. 2003;107:659–63.CrossRef Brad A, Grossman W. Evaluation and management of diastolic heart failure. Circulation. 2003;107:659–63.CrossRef
18.
go back to reference Kitzman OW, Litte WC, Brubaker PH, et al. Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure. JAMA. 2002;288:2144–50.PubMedCrossRef Kitzman OW, Litte WC, Brubaker PH, et al. Pathophysiological characterization of isolated diastolic heart failure in comparison to systolic heart failure. JAMA. 2002;288:2144–50.PubMedCrossRef
19.
go back to reference Pascual M, Pascual DA, Soria F. Effects of isolated obesity on systolic and diastolic left ventricular function. Heart. 2003;89:1127–9.CrossRef Pascual M, Pascual DA, Soria F. Effects of isolated obesity on systolic and diastolic left ventricular function. Heart. 2003;89:1127–9.CrossRef
20.
go back to reference Kanoupakis E, Michaloudis D, Fraidakis O, et al. Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity. Obes Surg. 2001;11:552–8.PubMedCrossRef Kanoupakis E, Michaloudis D, Fraidakis O, et al. Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity. Obes Surg. 2001;11:552–8.PubMedCrossRef
Metadata
Title
Morphofunctional Evaluation of the Heart of Obese Patients Before and After Bariatric Surgery
Authors
Antonio Carlos Valezi
Vitor Hugo Soares Machado
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 11/2011
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-011-0431-0

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