Objective: To study the systolic and diastolic function of asymptomatic patients with severe obesity using a Doppler echocardiography.Methods: Thirty candidates for bariatric surgery, with an average BMI of 49.2 ± 8.8 Kg/m2 and no previous history of heart disease were evaluated through transthoracic echocardiography. Results:Enlarged left chambers were observed in 42.9% of the sample, diastolic dysfunction in 54.6% and left ventricular hypertrophy in 82.1%, of which 50% of the cases presented the geometric pattern of eccentric hypertrophy. Indexation of left ventricular mass to height resulted in a significantly higher number of diagnoses for hypertrophy than indexation to body surface area (p = 0.0053), demonstrating that this index is more appropriate to determine ventricular hypertrophy in obese people. Correlations between left ventricular hypertrophy with obesity duration and pressure levels were positive as well as correlations between body mass index and diastolic dysfunction indicators. Conclusion:This study demonstrated that echocardiograms performed on asymptomatic severely obese patients can detect alterations in the cardiac structure that are common in cases of obesity cardiomyopathy and can be associated with the development of heart failure, arrhythmias and sudden death, enabling the identification of patients with greater cardiovascular risk.

SummaryObjective: Describe arterial blood pressure response in adolescents undergoing exercise stress testing.Methods: This was a cross-sectional study conducted with 218 adolescents (131 of whom were males), aged between 10 to 19 years, undergoing exercise stress testing. Maximum heart rate, total exercise time, maximum oxygen uptake, systolic blood pressure (SBP) and diastolic (DBP) at rest, during maximal physical exertion and at six minutes of recovery were measured.Results: At rest, SBP values were greater in males and no difference was found in DBP between genders, although both increased with age. During exercise, SBP rose and DBP fell in both genders. SBP variation was greater in men, particularly in those over 14 years of age.Conclusion: Analysis of results showed that during physical exercise, SBP had a direct relationship with the individual's age, weight, height and body mass index, whereas DBP bore a relationship to age only.

Background: The presence of structural and functional changes in the left ventricle (LV) are good predictors of cardiovascular events in patients with chronic kidney disease (CKD) and are associated with decreasing renal function. Studies in CKD patients on hemodialysis evidenced associations of serum 25-OH vitamin D (vit D) with myocardial function and structural changes. However, it is not known whether serum vit D is associated with Doppler echocardiogram (ECHO)-based cardiac changes in patients with CKD managed conservatively. Hypothesis: Hypovitaminosis D is associated with ECHObased cardiac changes in patients with CKD managed conservatively. Methods: This cross-sectional study included patients with CKD managed conservatively at a reference nephrology outpatient clinic. CKD stage was classified according to the KDIGO guidelines. The glomerular filtration rate was estimated by the CKD-EPI equation. Serum vit D was classified as insufficient/deficient when < 30 ng/mL and as normal when ≥ 30 ng/mL. ECHO-based cardiac changes were classified according to the American Society of Echocardiography criteria. Results: Serum vit D was measured in 137 of the 141 study patients, and 112 patients underwent ECHO. The mean age was 58.8 ± 16.0 years. Most patients were female and 80% self-reported being non-blacks. In multivariate analysis, insufficient/deficient serum vit D levels were independent risk factors for changes in ventricular geometry (OR: 3.85; p = 0.041) and reduced LV ejection fraction (OR: 1.06; p = 0.044), when compared to normal vit D serum levels. Conclusion: In patients with CKD managed conservatively, hypovitaminosis D is independently associated with structural and functional changes in the heart.

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