title: Effects of bariatric surgery on early myocardial alterations in adult severely obese subjects.
abstract: OBJECTIVE
  Aim of this study was to investigate the effect of weight loss on structural and functional myocardial alterations in severely obese subjects treated with bariatric surgery.
  
  
  METHODS
  Thirteen severely obese patients (2 males and 11 females) were enrolled in the study. All subjects underwent conventional 2D color Doppler echocardiography. The new ultrasonic techniques used were: (a) integrated backscatter for the analysis of myocardial reflectivity, referred to pericardial interface as expression of myocardial structure (increase in collagen content) and of cyclic variation index as expression of intrinsic myocardial contractility and (b) color Doppler myocardial imaging (CDMI) for the analysis of strain and strain rate (myocardial deformability). All subjects underwent bariatric surgery and were resubmitted to echocardiographic and biochemical examination 6-24 months after surgery.
  
  
  RESULTS
  The main finding of the present study was a quite complete normalization of myocardial functional and structural alterations after weight loss. In particular, the cyclic variation index at septum level improved from 14.6 +/- 7.0 before to 25.7 +/- 11.2 (means +/- SD) after surgery (controls: 36.2 +/- 9.1). Mean reflectivity at septum level significantly decreased from 55.8 +/- 9.5 to 46.5 +/- 8.8 (controls: 43.0 +/- 8.0). Also, the strain at septum level significantly improved after surgery (from -11.9 +/- 3.2 to -20.4 +/- 5.3; controls: -23.4 +/- 9).
  
  
  CONCLUSIONS
  This study establishes: (a) the utility of new ultrasonic techniques to detect very early structural and functional myocardial alterations in severely obese patients, and (b) the regression of these subclinical abnormalities after weight loss achieved by bariatric surgery.
authors.affiliation: Cardiac Thoracic and Vascular Department, University of Pisa, Pisa, Italy. vdibello@med.unipi.it
authors.forename: Vitantonio
authors.initials: V
authors.lastname: Di Bello
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Santini
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Cori
authors.forename: Andrea
authors.initials: A
authors.lastname: Pucci
authors.forename: Enrica
authors.initials: E
authors.lastname: Talini
authors.forename: Caterina
authors.initials: C
authors.lastname: Palagi
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Delle Donne
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marsili
authors.forename: Paola
authors.initials: P
authors.lastname: Fierabracci
authors.forename: Rocco
authors.initials: R
authors.lastname: Valeriano
authors.forename: Giovanna
authors.initials: G
authors.lastname: Scartabelli
authors.forename: Monica
authors.initials: M
authors.lastname: Giannetti
authors.forename: Marco
authors.initials: M
authors.lastname: Anselmino
authors.forename: Aldo
authors.initials: A
authors.lastname: Pinchera
authors.forename: Mario
authors.initials: M
authors.lastname: Mariani
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D018618:Echocardiography, Doppler, Color; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008297:Male; D009206:Myocardium / Q000473:pathology*; D009765:Obesity / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D015431:Weight Loss