Evolutive echocardiographic study of the structural and functional heart alterations in obese individuals after bariatric surgery.
OBJECTIVE
To evaluate with Doppler echocardiography the reversibility of structural and hemodynamic changes in obeses after bariatric surgery.


METHODS
Twenty-three patients (19 women = 82.6%) were studied. Mean age was 37.9 years. All subjects had Class III or Class II obesity with comorbidity and were submitted to bariatric surgery. Clinical and echocardiographic evaluation were performed preoperatively, in 6 months and 3 years after surgery.


RESULTS
Preoperatively, the mean weight and blood pressure (BP) were respectively 128.7 +/- 25.8 kg and 142.2 +/- 16.2 / 92.2 +/- 10.4 mmHg. Postoperatively, they showed important body weight reduction in 6 months (97.6 +/- 18.3 kg) and 3 years (83.6 +/- 13.5 kg), and BP reduction in 6 months (128.5 +/- 16.1/80.7 +/- 9.9 mmHg) that remain stable in 3rd year. On echocardiogram, preoperatively, there was hypertrophy of the septum and posterior wall associated with normal diastolic dimension; the predominant LV geometric pattern was concentric remodeling (74%). At six months, thinning of the ventricular septum and LV posterior wall, and increase in LV diastolic dimension were demonstrated. At 3rd year, the predominant LV pattern was normal (69%), with reduction of LV mass and LV mass/height2 index. We noticed improved diastolic function, with an increased E/A ratio and a decreased LV isovolumic relaxation time. The Myocardial Performance Index was obtained retrospectively in 13 patients and improved in 6 months. There was an increase of the ejection time in 6 months and an elevation of the ejection fraction in 3rd year, suggesting improvement of the LV systolic function.


CONCLUSIONS
The weight loss obtained with bariatric surgery promotes both structural and functional myocardial changes that improve cardiac performance.
Cunha
Luciana de Cerjat Bernardes P
Lde C
Hospital de Clínicas da Universidade Federal do Paraná e Programa de Pós-Graduação em Medicina Interna da Universidade Federal do Paraná, Curitiba, PR, Brazil. cpcunha@cardiol.br
da Cunha
Cláudio L Pereira
CL
de Souza
Admar Moraes
AM
Chiminacio Neto
Nelson
N
Pereira
Ricardo Soares
RS
Suplicy
Henrique Lacerda
HL
D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016277:Ventricular Function, Left / Q000502:physiology*