Major weight loss prevents long-term left atrial enlargement in patients with morbid and extreme obesity
Major weight loss prevents long-term left atrial enlargement in patients with morbid and extreme obesity
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DOI：
10.1093/ejechocard/jen117
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发表时间：
2008-09-01
影响因子：
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通讯作者：
Lopez-Jimenez, Francisco
中科院分区：
文献类型：
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作者：
Garza, Carolina A.;Pellikka, Patricia A.;Lopez-Jimenez, Francisco
目的 评估病态肥胖 [体重指数 (BMI) >= 35 kg/m(2) 合并症] 和极度肥胖 (BMI >= 40 kg/m(2)) 患者在胃绕道手术后体重减轻 (WL) 后左心房 (LA) 体积的长期变化。 方法和结果 我们回顾了 57 名接受胃绕道手术并在手术前后进行超声心动图检查的患者。对照组的体重指数、性别、年龄和随访时间进行频率匹配。平均随访 3.6 年后，接受减肥手术的患者 LA 体积没有显着变化，但对照组增加了 15 +/- 28 ml (P < 0.0001)，身高指数 LA 体积增加了 0.1 +/- 0.2 ml (P < 0.0001)，在调整潜在混杂因素后，病例和对照组之间的差异仍然显着 (P = 0.01)。在整个研究人群中，体重变化和 LA 体积变化之间存在正相关（r = 0.22，P = 0.006），与 LA 扩大相关的临床状况无关。 结论 体重变化与 LA 体积变化相关，与肥胖相关的合并症无关。减肥手术成功诱导的 WL 可防止 LA 体积逐渐增加。
Aims To assess long-term changes in left atrial (LA) volume in patients with morbid obesity [body mass index (BMI) >= 35 kg/m(2) with co-morbidities] and extreme obesity (BMI >= 40 kg/m(2)), after surgically-induced weight loss (WL) after gastric bypass surgery.Methods and results We reviewed 57 patients who underwent gastric bypass surgery and had echocar-diograms both before and after the operation. A control group was frequency-matched for BMI, sex, age, and for duration of follow-up. After a mean follow-up of 3.6 years, LA volume did not change significantly in patients who underwent bariatric surgery, but increased in the control group by 15 +/- 28 ml (P < 0.0001), and 0.1 +/- 0.2 ml (P < 0.0001) for height-indexed LA volume, with a difference between cases and controls that remained significant after adjusting for potential confounders (P = 0.01). In the study population as a whole, there was a positive correlation between change in body weight and change in LA volume (r = 0.22, P = 0.006) independent of clinical conditions associated with LA enlargement.Conclusion Change in body weight is associated with change in LA size independent of obesity-associated co-morbidities. Successful WL induced by bariatric surgery prevents the progressive increase in LA volume.