Cardiology Division, Georgia Health Sciences University, Augusta, Georgia 30912, USA.
Curr Opin Cardiol. 2011 Nov;26(6):555-61. doi: 10.1097/HCO.0b013e32834b7fc4.
Obesity is commonly associated with multiple conditions imparting adverse cardiovascular risk, including hypertension, dyslipidemia, and insulin resistance or diabetes. In addition, sleep disordered breathing, inflammation, left ventricular hypertrophy, left atrial enlargement, and subclinical left ventricular systolic and diastolic dysfunction may collectively contribute to increased cardiovascular morbidity and mortality. This review will describe improvements in cardiovascular risk factors after bariatric surgery.
All of the cardiovascular risk factors listed above are improved or even resolved after bariatric surgery. Cardiac structure and function also have shown consistent improvement after surgically induced weight loss. The amount of improvement in cardiac risk factors is generally proportional to the amount of weight lost. The degree of weight loss varies with different bariatric procedures. On the basis of the improvement in risk profiles, it has been predicted that progression of atherosclerosis could be slowed and the 10-year risk of cardiac events would decline by ~50% in patients undergoing weight loss surgery. In keeping with these predictions, two studies have demonstrated reductions in 10-year total and cardiovascular mortality of approximately 50% in patients who had bariatric surgery.
These encouraging data support the continued, and perhaps expanded, use of surgical procedures to induce weight loss in severely obese patients.
肥胖通常与多种不良心血管风险因素相关，包括高血压、血脂异常、胰岛素抵抗或糖尿病。此外，睡眠呼吸障碍、炎症、左心室肥厚、左心房增大以及亚临床左心室收缩和舒张功能障碍可能共同导致心血管发病率和死亡率的增加。本篇综述将描述减重手术后心血管危险因素的改善情况。
上述所有心血管危险因素在减重手术后均得到改善甚至解决。心脏结构和功能在手术诱导体重减轻后也显示出一致的改善。心脏危险因素的改善程度通常与体重减轻的程度成正比。不同减重手术的减重程度不同。基于风险特征的改善，有人预测接受减肥手术的患者动脉粥样硬化进展可能会减缓，10 年内心脏事件的风险将下降约 50%。有两项研究证实，接受减重手术的患者 10 年全因和心血管死亡率降低约 50%，与这些预测相符。
这些令人鼓舞的数据支持继续（或许扩大）使用手术程序来诱导严重肥胖患者减轻体重。
