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减重手术改善病态肥胖患者的心电图异常。

Bariatric surgery mitigated electrocardiographic abnormalities in patients with morbid obesity.

机构信息

Shiraz University of Medical Sciences, Shiraz, Iran.

Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Sci Rep. 2024 Mar 20;14(1):6710. doi: 10.1038/s41598-024-57155-2.

DOI:10.1038/s41598-024-57155-2
PMID:38509211
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10954646/
Abstract

Obesity can lead to cardiovascular dysfunctions and cause electrocardiographic disruptions. Bariatric surgery plays a significant role in weight loss. To assess its benefits, this study investigated electrocardiographic changes before and after bariatric surgery. The present article describes a retrospective cohort study with a 6-month follow-up period. Electrocardiograms were interpreted and compared before and six months after surgery. The relationships between weight loss, type of surgery, and electrocardiographic alterations were analyzed. A total of 200 patients participated in the study, with 34 (17%) men and 166 (83%) women. The mean age of the participants was 44.6 ± 8.6, and their mean body mass index was 43.8 ± 5.5 kg/m. The mean of QTc decreased after the surgery, while the Sokolow-Lyon scores increased. The statistical analysis showed that QTc dispersion (> 40) (P < 0.001), right ventricular hypertrophy (P < 0.001), abnormal R wave progression (P < 0.001), QTc (P < 0.001) and Sokolow-Lyon criteria (P < 0.001) significantly changed postoperatively. In conclusion, bariatric surgery can reduce QTc, correct poor R wave progression, and resolve right ventricular hypertrophy (RVH) in patients with morbid obesity.

摘要

肥胖可导致心血管功能障碍,并引起心电图异常。减重手术在减肥方面起着重要作用。为了评估其益处,本研究调查了减重手术前后的心电图变化。本文描述了一项具有 6 个月随访期的回顾性队列研究。在手术前和手术后 6 个月对心电图进行解读和比较。分析了体重减轻、手术类型与心电图改变之间的关系。共有 200 名患者参与了这项研究,其中 34 名(17%)为男性,166 名(83%)为女性。参与者的平均年龄为 44.6±8.6 岁,平均体重指数为 43.8±5.5kg/m。手术后 QTc 降低,而 Sokolow-Lyon 评分增加。统计分析显示,手术后 QTc 离散度(>40)(P<0.001)、右心室肥厚(P<0.001)、R 波异常进展(P<0.001)、QTc(P<0.001)和 Sokolow-Lyon 标准(P<0.001)均显著改变。总之,减重手术可降低肥胖患者的 QTc、纠正不良的 R 波进展并解决右心室肥厚(RVH)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e64/10954646/3e2b4642d483/41598_2024_57155_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e64/10954646/3e2b4642d483/41598_2024_57155_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e64/10954646/3e2b4642d483/41598_2024_57155_Fig1_HTML.jpg

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本文引用的文献

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Long-Term Weight Outcomes after Bariatric Surgery: A Single Center Saudi Arabian Cohort Experience.减重手术后的长期体重结果:沙特阿拉伯单中心队列经验
J Clin Med. 2021 Oct 25;10(21):4922. doi: 10.3390/jcm10214922.
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Effects of Bariatric Surgery on Heart Rhythm Disorders: a Systematic Review and Meta-Analysis.减重手术对心律紊乱的影响:系统评价和荟萃分析。
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Interaction of obesity and atrial fibrillation: an overview of pathophysiology and clinical management.
肥胖与心房颤动的相互作用:病理生理学与临床管理概述
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Cardiac structure and function before and after bariatric surgery: a clinical overview.减重手术后的心脏结构与功能:临床概述
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Gastric Bypass Surgery Produces a Durable Reduction in Cardiovascular Disease Risk Factors and Reduces the Long-Term Risks of Congestive Heart Failure.胃旁路手术可持久降低心血管疾病风险因素,并降低充血性心力衰竭的长期风险。
J Am Heart Assoc. 2017 May 23;6(5):e005126. doi: 10.1161/JAHA.116.005126.
7
Risk of Heart Failure in Obese Patients With and Without Bariatric Surgery in Sweden-A Registry-Based Study.瑞典肥胖患者接受和不接受减重手术与心力衰竭风险的关系:一项基于登记的研究。
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8
2017 ISHNE-HRS expert consensus statement on ambulatory ECG and external cardiac monitoring/telemetry.2017ISHNE-HRS 专家共识声明:动态心电图和外部心脏监测/遥测。
Heart Rhythm. 2017 Jul;14(7):e55-e96. doi: 10.1016/j.hrthm.2017.03.038. Epub 2017 May 8.
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