Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity

Citation
E. Kanoupakis et al., Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity, OBES SURG, 11(5), 2001, pp. 552-558
Citations number
26
Categorie Soggetti
Surgery
Journal title
OBESITY SURGERY
ISSN journal
09608923 → ACNP
Volume
11
Issue
5
Year of publication
2001
Pages
552 - 558
Database
ISI
SICI code
0960-8923(200110)11:5<552:LVFACP>2.0.ZU;2-3
Abstract
Background: It is well established that morbid obesity affects the respirat ory system and the diastolic function of the heart. During exercise, cardio pulmonary reserve is exhausted because of augmented requirements, leading t o a significant intolerance. A study was undertaken to investigate the infl uence of body weight loss on the characteristics of the left ventricle (LV) and on exercise capacity in obese patients before and 6 months following v ertical banded gastroplasty (VBG). Methods: 16 morbidly obese individuals (BMI >40 kg/m(2)) scheduled for VBG were studied. A symptom-limited cardiopulmonary exercise test and a complet e transthoracic echocardiogram were performed 1 day before operation and 6 months postoperatively (after the patients achieved a body weight loss of g reater than or equal to 20% of their pre-operative values). Results: Exercise duration increased significantly 6 months following surge ry. The mean O-2 consumption at peak exercise (peak VO2) and at the anaerob ic threshold (VO2AT) was significantly higher after weight loss. 6 months a fter VBG the LV thickness decreased significantly. Regarding the diastolic indices, isovolumic relaxation time (IVRT) and early/late (E/A) velocity ra tio, there was a significant improvement after weight loss. Simple linear r egression analysis revealed that peak VO2 and VO2AT were significantly corr elated with IVRT and E/A velocity ratio. Conclusions: Weight loss after VBG improves the cardiac diastolic function and this is associated with an improvement in cardiopulmonary exercise perf ormance. Left ventricular filling variables could be considered among the m ost important determinants of exercise intolerance in obese individuals.