title: Evolutive echocardiographic study of the structural and functional heart alterations in obese individuals after bariatric surgery.
abstract: 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.
authors.affiliation: 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
authors.forename: Luciana de Cerjat Bernardes P
authors.initials: Lde C
authors.lastname: Cunha
authors.forename: Cláudio L Pereira
authors.initials: CL
authors.lastname: da Cunha
authors.forename: Admar Moraes
authors.initials: AM
authors.lastname: de Souza
authors.forename: Nelson
authors.initials: N
authors.lastname: Chiminacio Neto
authors.forename: Ricardo Soares
authors.initials: RS
authors.lastname: Pereira
authors.forename: Henrique Lacerda
authors.initials: HL
authors.lastname: Suplicy
mesh_terms: 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*