Beneficial Cardiovascular Effects of Bariatric Surgical and Dietary Weight Loss in Obesity
Beneficial Cardiovascular Effects of Bariatric Surgical and Dietary Weight Loss in Obesity
复制标题
DOI：
10.1016/j.jacc.2009.02.086
复制
发表时间：
2009-08-18
影响因子：
24
通讯作者：
Neubauer, Stefan
中科院分区：
文献类型：
--
作者：
Rider, Oliver J.;Francis, Jane M.;Neubauer, Stefan
目的我们假设，在没有合并症的肥胖人群中，通过减肥手术或饮食减轻体重时，对超重的心血管反应是可逆的。是心血管风险的独立预测因子。（体重指数40 +/- 8 kg/m2）和20名无可识别心脏危险因素的正常体重受试者（体重指数21 +/- 2 kg/m2）进行心脏磁共振成像，以评估左心室和右心室以及主动脉功能指数。30名肥胖受试者在体重显著减轻1年后接受了重复成像，其中17名受试者通过饮食和13名受试者通过减肥手术实现。结果肥胖组左、右心室重量明显增加，左心室舒张功能受损，主动脉扩张性降低。饮食和减肥手术都导致左心室和右心室质量、舒张末期容积和舒张功能障碍相当、显着下降，以及主动脉所有水平的主动脉扩张性增加，最明显的是远端（例如。例如，在一个实施例中，降主动脉远端体重减轻前为5.1 +/- 1.8 mm Hg-1 x 10（-3），体重减轻后为6.8 +/- 2.5 mm Hg-1 x 10（-3）; p < 0.001）。没有改善观察到在持续obesity.Conclusions的方法，1年的减肥导致部分回归的心脏肥大和逆转舒张功能障碍和主动脉扩张性损害。这些发现提供了一个潜在的机制，降低死亡率与体重减轻。（美国科尔心脏病学杂志2009; 54：718-26）（C）2009年美国心脏病学会基金会
Objectives We hypothesized that, in obese persons without comorbidities, cardiovascular responses to excess weight are reversible during weight loss by either bariatric surgery or diet.Background Obesity is associated with cardiac hypertrophy, diastolic dysfunction, and increased aortic stiffness, which are independent predictors of cardiovascular risk.Methods Thirty-seven obese (body mass index 40 +/- 8 kg/m(2)) and 20 normal-weight subjects (body mass index 21 +/- 2 kg/m2) without identifiable cardiac risk factors underwent cardiac magnetic resonance imaging for the assessment of the left and right ventricles and of indexes of aortic function. Thirty of the obese subjects underwent repeat imaging after 1 year of significant weight loss, achieved in 17 subjects by diet and in 13 subjects by bariatric surgery. Seven obese subjects underwent repeat imaging after 1 year of continued obesity.Results Left and right ventricular masses were significantly increased, left ventricular diastolic function impaired, and aortic distensibility reduced in the obese. Both diet and bariatric surgery led to comparable, significant decreases in left and right ventricular masses, end-diastolic volume, and diastolic dysfunction, and an increase in aortic distensibility at all levels of the aorta, most pronounced distally (e. g., distal descending aorta 5.1 +/- 1.8 mm Hg-1 x 10(-3) before weight loss and 6.8 +/- 2.5 mm Hg-1 x 10(-3) after weight loss; p < 0.001). No improvements were observed in continued obesity.Conclusions Irrespective of method, 1 year of weight loss leads to partial regression of cardiac hypertrophy and to reversal of both diastolic dysfunction and aortic distensibility impairment. These findings provide a potential mechanism for the reduction in mortality seen with weight loss. (J Am Coll Cardiol 2009; 54: 718-26) (C) 2009 by the American College of Cardiology Foundation