Modificaciones anatomofuncionales del corazón en la obesidad mórbida. Cambios tras la cirugía bariátrica
2011; Elsevier BV; Volume: 65; Issue: 1 Linguagem: Inglês
10.1016/j.recesp.2011.06.018
ISSN1579-2242
AutoresMaría Luaces, Victoria Cachofeiro, Alejandro García-Muñoz-Najar, Manuel Medina, Noemí González, Emilia Cáncer, Azucena Rodríguez-Robles, Gloria Cánovas, Alfonso Antequera-Pérez,
Tópico(s)Cardiovascular Disease and Adiposity
ResumoCardiac adaptation to obesity includes both structural and functional changes in the heart. The therapeutic option of last resort for morbidly obese patients is bariatric surgery. This study aims to assess the anatomical functional changes in the heart for a Spanish cohort of morbidly obese patients, as well as changes after bariatric surgery.Patients referred for bariatric surgery were prospectively included. In each case, a transthoracic echocardiography, electrocardiogram, and blood tests were performed before the procedure and repeated 1 year after surgery.Forty-one patients completed the 1-year follow-up. Of these, 82.9% were female. Mean age was 40.2±9.6 years. Prior to surgery, mean body mass index was 47.41 kg/m(2), decreasing to 30.43 kg/m(2) after the procedure. Before surgery, cardiac remodeling was present in 70.7%, most frequently in the form of eccentric hypertrophy (34.1%). At 1-year follow-up, 58.5% showed a normal left ventricular geometric pattern (P=.02). Mitral inflow E/A ratio changed from 1.14 to 1.43 (P<.001). Nevertheless, early mitral velocity measured by Doppler tissue decreased (P=.06).In morbidly obese patients referred for bariatric surgery, cardiac remodeling is highly prevalent, in most cases in an eccentric manner. Weight loss achieved by bariatric surgery is accompanied by significant improvements in left ventricular structure. Nevertheless, the damage in diastolic function may be permanent despite weight loss.
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