Avaliação ecocardiográfica em obesos graves assintomáticos

Abstract

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.

Função diastólica do ventrículo esquerdo em obesos graves em pré-operatório para cirurgia bariátrica

“…When left ventricular diastolic function was assessed, there was a reduction in diastolic function in 53.8% of patients, a fact which is not common in the young age group as in this sample, aged 38.5 years (± 10.5). Okawa's study 24 with 104 morbidly obese patients, found 62.4% of diastolic dysfunction, while another study by Rocha et al 25 found in 30 patients in the preoperative period for bariatric surgery, 54.6% of diastolic dysfunction. Studies on the prevalence of diastolic dysfunction in obese diabetic patients showed a prevalence of 47% when using mitral flow 26 ; Boyer et al 27 , when associated flow propagation and color M-mode tissue Doppler to mitral flow analysis, found a prevalence of 75% of LV diastolic dysfunction, and tissue Doppler detected diastolic dysfunction in 63% of patients.…”

Avaliação da pressão arterial sistêmica em cães obesos: comparação entre os métodos oscilométrico e doppler ultrassônico

“…A presença e a intensidade das alterações cardiovasculares em pacientes obesos dependem e são proporcionais ao tempo de instalação e convivência com as alterações hemodinâmicas e gravidade da obesidade (Rocha et al 2007). Portanto, a ausência da elevação significativa da pressão arterial verificada nessa amostra de cães obesos por meio de diferentes métodos de mensuração indireta, pode ser devido ao fato de alguns animais avaliados não apresentarem obesidade pronunciada (escore de condição corporal = 9) ou pelo fato dos cães não possuírem expectativa de vida longa o suficiente em excesso de peso corporal, condição necessária para afetar o controle da pressão arterial sistêmica.…”

Bifocal Right Ventricular Resynchronization for the Failing Right Ventricle

“…Bifocal RV pacing has been tested in small studies as a treatment option for patients with LV systolic dysfunction and heart failure. [2][3][4] These studies have shown clinical and echocardiographic improvement 2-4 although in a lesser extent as compared with biventricular pacing. 3 The capacity of shortening the LV activation time with bifocal RV pacing is probably the underlying mechanism to benefit from this pacing mode.…”

“…[2][3][4] These studies have shown clinical and echocardiographic improvement 2-4 although in a lesser extent as compared with biventricular pacing. 3 The capacity of shortening the LV activation time with bifocal RV pacing is probably the underlying mechanism to benefit from this pacing mode. 5,6 However, in accordance with the clinical results, this shortening is higher with biventricular pacing or LV pacing with fusion with intrinsic depolarization.…”