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减肥手术后显著体重减轻对超声心动图指标的影响:一项聚焦二维斑点超声心动图测量左心室变形及右心室大小的观察性研究

The effect of significant weight loss after bariatric surgery on echocardiographic indices: an observational study focusing on left ventricular deformation by 2D speckle echocardiography and right ventricular size.

作者信息

Safari Saeed, Parsaee Mozhgan, Moradi Mohammad, Hakiminejad Mahdi, Koohsari Parisa, Larti Farnoosh

机构信息

General Surgery Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran.

Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Egypt Heart J. 2024 Apr 8;76(1):44. doi: 10.1186/s43044-024-00474-6.

Abstract

BACKGROUND

Obesity is a known risk factor for atherosclerosis and cardiac disease.

HYPOTHESIS

This study evaluated the effect of significant weight loss following bariatric surgery on myocardial deformation indices and right ventricular size (RV). This was a prospective cohort study. Morbid obese patients scheduled for bariatric surgery from July 2017 to February 2018 at Firoozgar Hospital were included in our study and referred for transthoracic echocardiography at Rajaie Cardiovascular Medical and Research Center.

RESULTS

Thirty-four patients entered the study. The absolute value of global longitudinal strain (GLS) at baseline, 3, and 6 months after surgery was 17.42 ± 2.94%, 18.24 ± 3.09%, and 19.52 ± 2.78%, respectively, with a statistically significant difference from baseline to after six months (P value < 0.001). The absolute value of global circumferential strain (GCS) at baseline, 3, and 6 months after surgery was 20.14 ± 4.22%, 23.32 ± 4.66%, and 24.53 ± 4.52%, respectively, with statistically significant changes (P value < 0.001) from baseline to three months and from baseline to six months and no significant difference from three months to six months. A significant decrease was reported in mechanical dispersion of circumferential strain (38.05 ± 23.81-23.37 ± 20.86 ms, P value = 0.006) 6 months after surgery. Right ventricular size three- and six-month post-surgery showed a significant decrease relative to baseline echocardiography.

CONCLUSIONS

Bariatric surgery could enhance cardiac function, as proven by 2D speckle echocardiography. Changes in RV size may be related to weight loss and should be considered when assessing patients who have undergone bariatric surgery.

摘要

背景

肥胖是动脉粥样硬化和心脏病的已知风险因素。

假设

本研究评估了减肥手术后显著体重减轻对心肌变形指数和右心室大小(RV)的影响。这是一项前瞻性队列研究。2017年7月至2018年2月在菲鲁兹加尔医院计划进行减肥手术的病态肥胖患者被纳入我们的研究,并被转诊至拉贾伊心血管医学和研究中心进行经胸超声心动图检查。

结果

34名患者进入研究。术后基线、3个月和6个月时整体纵向应变(GLS)的绝对值分别为17.42±2.94%、18.24±3.09%和19.52±2.78%,从基线到6个月后有统计学显著差异(P值<0.001)。术后基线、3个月和6个月时整体圆周应变(GCS)的绝对值分别为20.14±4.22%、23.32±4.66%和24.53±4.52%,从基线到3个月以及从基线到6个月有统计学显著变化(P值<0.001),从3个月到6个月无显著差异。术后6个月圆周应变的机械离散度显著降低(38.05±23.81 - 23.37±20.86毫秒,P值 = 0.006)。术后3个月和6个月时右心室大小相对于基线超声心动图显示显著减小。

结论

减肥手术可增强心脏功能,二维斑点追踪超声心动图已证实这一点。右心室大小的变化可能与体重减轻有关,在评估接受减肥手术的患者时应予以考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d40/11001804/bbd435f870ea/43044_2024_474_Fig1_HTML.jpg

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