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Published on: November 28, 2018
Left ventricular diastolic function in morbidly obese patients in the preoperative for bariatric surgery
Irlaneide da Silva Tavares1, Antonio Carlos Sobral Sousa, Raimundo Sotero Menezes Filho
1Departamento de Medicina - Universidade Federal de Sergipe, São Cristóvão, SE, Brazil. irlaneide@cardiol.br
Insights
Morbidly obese patients often have preclinical left ventricular diastolic dysfunction, increasing cardiovascular risk. Early echocardiographic screening is crucial for identifying high-risk individuals before surgery.
Area of Science:
- Cardiology
- Obesity Medicine
- Diagnostic Imaging
Background:
- Obesity is a complex disease linked to significant cardiovascular risks, particularly diastolic heart failure.
- Morbid obesity presents unique challenges for cardiovascular health, necessitating detailed assessment.
Purpose of the Study:
- To assess left ventricular diastolic function in individuals with morbid obesity prior to bariatric surgery.
- To correlate diastolic function with cardiovascular risk factors and cardiac structure in this population.
Main Methods:
- A cross-sectional study involving 132 patients undergoing bariatric surgery evaluation.
- Transthoracic echocardiography and cardiovascular risk factor assessment were performed.
- Patients were categorized based on diastolic function: normal, mild dysfunction, and moderate/severe dysfunction.
Main Results:
- Hypertension, age, and gender significantly differed between groups with and without diastolic dysfunction.
- Patients with diastolic dysfunction exhibited enlarged left atrial and ventricular dimensions and increased left ventricular mass index.
- Specific patterns observed included pseudonormal and restrictive diastolic dysfunction.
Conclusions:
- Left ventricular diastolic dysfunction is prevalent in the preclinical stage of morbid obesity.
- Routine echocardiographic evaluation is essential for identifying at-risk patients.
- Early detection facilitates timely intervention to mitigate cardiovascular complications.
Background:
Obesity is a chronic and multifactorial disease, associated with increased cardiovascular risk, especially diastolic heart failure.
Objective:
To evaluate left ventricular diastolic function in morbidly obese patients in the pre-operative for bariatric surgery, correlating it with cardiovascular risk factors and heart structure.
Methods:
This is a cross-sectional study with 132 patients eligible for bariatric surgery submitted to transthoracic echocardiography assessment and of cardiovascular risk factors, as follows: 97 women (73.5%), mean age 38.5 ± 10.5 years and BMI of 43.7 ± 7.2 kg / m(2). Patients were divided into three groups: 61 with normal diastolic function, 24 with mild diastolic dysfunction and 47 with moderate/severe diastolic dysfunction, of which 41 with moderate diastolic dysfunction (pseudonormal pattern) and six with severe diastolic dysfunction (restrictive pattern).
Results:
Hypertension, age and gender were different in the groups with diastolic dysfunction. Groups with dysfunction had higher left atrial diameter, left ventricular diameter, left atrial volume in four and two chambers, left atrial volume index and left ventricular mass index corrected for body surface area and height.
Conclusion:
The high frequency of left ventricular diastolic dysfunction in the preclinical phase in morbidly obese patients justifies the need for careful echocardiographic assessment, aiming at identifying individuals at higher risk, so that early intervention measures can be carried out.
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