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减重手术后双侧腿部水肿:硒缺乏性心肌病。

Bilateral leg oedema after bariatric surgery: A selenium-deficient cardiomyopathy.

机构信息

Department of Cardiovascular Diseases, Laveran Military Teaching Hospital, Marseille, France.

Department of Cardiovascular Diseases, Laveran Military Teaching Hospital, Marseille, France.

出版信息

Obes Res Clin Pract. 2017 Sep-Oct;11(5):622-626. doi: 10.1016/j.orcp.2017.05.004. Epub 2017 Jun 10.

Abstract

This report describes a case of selenium-deficient cardiomyopathy secondary to bariatric surgery (Roux-en-Y gastric bypass surgery). A 40 year-old woman presented with bilateral leg oedema nine months after the surgical procedure. Timely diagnosis of selenium-deficient cardiomyopathy was due to the recognition of symptoms of heart failure, increased NT pro-BNP level, detection of myocardial diastolic dysfunction and impaired left ventricular global longitudinal strain by echocardiography, and early identification of selenium deficiency. Symptoms resolution, cardiac biomarkers and echocardiographic abnormalities normalization were observed after 3 months of oral selenium supplementation and conventional heart failure therapy. Any sign of heart failure after bariatric surgery should require screening for a nutrient-deficient cardiomyopathy.

摘要

本报告描述了一例继发于减重手术(Roux-en-Y 胃旁路手术)的硒缺乏性心肌病。一名 40 岁女性在手术九个月后出现双侧腿部水肿。由于认识到心力衰竭的症状、NT pro-BNP 水平升高、超声心动图检测到心肌舒张功能障碍和左心室整体纵向应变受损,以及早期发现硒缺乏,及时诊断出硒缺乏性心肌病。口服硒补充和常规心力衰竭治疗 3 个月后,观察到症状缓解、心脏生物标志物和超声心动图异常正常化。任何肥胖手术后心力衰竭的迹象都应该需要筛查营养缺乏性心肌病。

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