1. Effects of Bariatric Surgery on Early Myocardial Alterations in Adult Severely Obese Subjects
- Author
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Monica Giannetti, Mario Mariani, Ferruccio Santini, Caterina Palagi, Aldo Pinchera, Andrea Di Cori, Vitantonio Di Bello, Marco Anselmino, Maria Grazia Delle Donne, Enrica Talini, Paola Fierabracci, Rocco Valeriano, Giovanna Scartabelli, Andrea Pucci, and Alessandro Marsili
- Subjects
Adult ,Male ,medicine.medical_specialty ,Treatment outcome ,Obesity Strain Strain rate ,macromolecular substances ,Severity of Illness Index ,Insulin resistance ,Weight loss ,Internal medicine ,Weight Loss ,Severity of illness ,medicine ,Humans ,Pharmacology (medical) ,Obesity ,Bariatric surgery, Color Doppler, myocardial imaging, Insulin resistance, Integrated backscatter, Myocardial dysfunction, Obesity Strain Strain rate ,Integrated backscatter ,Bariatric surgery ,business.industry ,Myocardium ,Obesity Surgery ,Heart ,medicine.disease ,Myocardial dysfunction ,Echocardiography, Doppler, Color ,Surgery ,Treatment Outcome ,Cardiology ,Female ,Obese subjects ,Color Doppler ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,myocardial imaging - 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. Patients and 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). Conclusion: 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.
- Published
- 2007
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