title: Impact of Body Mass Index >50 on Cardiac Structural and Functional Characteristics and Surgical Outcomes After Bariatric Surgery.
abstract: Body mass index (BMI) ≥50.0 kg/m2has been associated with increased surgical complications and mortality. We assessed echocardiographic characteristics and bariatric surgery complications of patients with BMI ≥50.0 kg/m2vs. those in less severe obesity.
  
  
  
  A retrospective analysis in patients who underwent gastric bypass was performed. Pre-surgery structural characteristics analyzed included left atrial dimension (LA), left ventricle mass (LVM), LVM indexed for height2.7(LVMI), and LV hypertrophy (LVH). Functional characteristics included LV diastolic and systolic function. Degree of obesity was correlated with cardiac parameters, comorbidities, and surgical complications. Data on 312 patients (75.3 % women, age 39.3 ± 0.6 years, BMI 50.2 ± 0.5 kg/m2) were analyzed. Cardiac parameters on the basis of BMI (<50 kg/m2vs. ≥50 kg/m2) were LA 39.6 ± 4.8 vs. 41.9 ± 5.2 mm, LVM 161 ± 46 vs. 194 ± 56 g, LVMI 43.6 ± 0.9 vs. 51.8 ± 1.3 g/ht2.7, and systolic pulmonary pressure 43.7 ± 10.1 vs. 50.5 ± 11.3 mmHg, respectively (all p < 0.001). LVMI was correlated with BMI (p < 0.001), 2-h glucose on a glucose tolerance test (p = 0.01), and ejection fraction (p = 0.01). Surgical complications were not different among groups. Presence of LVH was independently associated with BMI ≥50 kg/m2and female sex, after adjusting for age, diabetes, hypertension, and pulmonary hypertension.
  
  
  
  Body mass index ≥50 kg/m2was independently associated with female sex and LVH but not with hypertension, diabetes, or a higher rate of surgical complications.
authors.affiliation: Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390, US.
authors.forename: Nicholas Keisuke
authors.initials: NK
authors.lastname: Brownell
authors.affiliation: Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico, Mexico. chelorf76@yahoo.com.
authors.forename: Marcela
authors.initials: M
authors.lastname: Rodriguez-Flores
authors.affiliation: Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico, Mexico.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Garcia-Garcia
authors.affiliation: Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico, Mexico.
authors.forename: Samuel
authors.initials: S
authors.lastname: Ordoñez-Ortega
authors.affiliation: Cardiology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Oseguera-Moguel
authors.affiliation: Endocrinology Department, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico, Mexico.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Aguilar-Salinas
authors.affiliation: Faculté de Pharmacie, Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Laval, Québec, Mexico.
authors.forename: Paul
authors.initials: P
authors.lastname: Poirier
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000534:rehabilitation; D015992:Body Mass Index; D003971:Diastole; D004452:Echocardiography; D005260:Female; D005951:Glucose Tolerance Test; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Echocardiography; Hypertrophy; Myocardium; Obesity; Women