Effects of Bariatric Surgery on Cardiovascular Function

Ashrafian, Hutan; Roux, Carel W. le; Darzi, Ara; Athanasiou, Thanos

doi:10.1161/circulationaha.107.721027

Cited by 209 publications

(180 citation statements)

References 140 publications

(130 reference statements)

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“…Obese individuals have a higher risk of developing myocardial dysfunction independent of the aforementioned causes 24. The haemodynamic and structural changes imposed on the heart as a result of obesity can range from a hyperdynamic state to overt systolic dysfunction.…”

Section: Obesity and The Risk Of Developing Heart Failurementioning

confidence: 99%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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Obesity and heart failure are two of the leading causes of morbidity and mortality in the world. The relationship between obesity and cardiovascular diseases is complex and not fully understood. While the risk of developing heart failure has been shown to be higher in patients who are obese, there is a survival advantage for obese and overweight patients compared with normal weight or low weight patients. This phenomenon was first described by Horwich et al. and was subsequently confirmed in other large trials. The advantage exists irrespective of the type, aetiology, or stage of heart failure. Patients with morbid obesity (body mass index >40 kg/m2), however, do not have the same survival advantage of their obese counterparts. There are several alternative indices of obesity available that may be more accurate than body mass index. The role of weight loss in patients with heart failure is unclear; thus, providing sound clinical advice to patients remains difficult. Future prospective trials designed to evaluate the link between obesity and heart failure will help us understand more fully this complex relationship.

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Section: Obesity and The Risk Of Developing Heart Failurementioning

confidence: 99%

Obesity paradox in heart failure: a heavy matter

et al. 2016

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“…Obesity is a worldwide pandemic, [1][2][3][4] with the number of obese children and adolescents increasing alarmingly. 5 This has serious health and socioeconomic implications due to the attendant increase in related comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Overview of bariatric surgery for the physician

Hng

Ang

2012

Clinical Medicine

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-The worldwide pandemic of obesity carries alarming health and socioeconomic implications. Bariatric surgery is currently the only effective treatment for severe obesity. It is safe, with mortality comparable to that of cholecystectomy, and effective in producing substantial and sustainable weight loss, along with high rates of resolution of associated comorbidities, including type 2 diabetes. For this reason, indications for bariatric surgery are being widened. In addition to volume restriction and malabsorption, bariatric surgery brings about neurohormonal changes that affect satiety and glucose homeostasis. Increased understanding of these mechanisms will help realise therapeutic benefits by pharmacological means. Bariatric surgery improves long-term mortality but can cause long-term nutritional deficiencies. The safety of pregnancy after bariatric surgery is still being elucidated.

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“…Combination of calcium blocker e.g amlodipine or vasodilating ββ or lower strength diuretic with potent RAAS blockade can negate this risk [6,21,29,31,[62][63][64][65][66][67][68][69]. Finally, cashing in on post-op weight loss with extended rehab and support are factors to discuss at unit case conferences, and when all options fail bariatric surgery in selected patients [15,70,71].…”

Section: Beta Blockersmentioning

confidence: 99%

“…Sleep apnea and respiratory conditions often co-exist in 30-40% and can be a diagnostic confounder. Improving IR improves HT and CHF [8,[12][13][14][15]];…”

Section: Introductionmentioning

confidence: 99%

Do We Need A Wider Therapeutic Paradigm For Heart Failure With Comorbidities?: A Remote Australian Perspective

Iyngkaran¹,

Thomas²

2016

Health Care: Current Reviews

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Forty percent of CHF clients can suffer with up to five or more comorbidity, a rate that is likely higher in the NT. Large CHF trials AbstractCongestive Heart Failure a leading cause of morbidity and mortality is often associated with comorbidities and with it polypharmacy. Improved pathophysiological understanding, the available therapeutics, clinical guidelines and structured programs for comprehensive care have not benefited all clients in the Northern Territory of Australia. The Northern Territory has both a unique geography and demography including a sizeable Indigenous population. Additional factors that can affect heart failure management are prevalent in remote areas and are not well addressed within randomized controlled trials. This review is focused on building a case for widening the therapeutic paradigm for heart failure with comorbidities. We focus on a brief overview of heart failure and its associated comorbidities, the common overlapping physiological processes, the interpretation of the external validity of trial evidence, and finally exploring the available evidence for the important therapies within the guidelines. A need to consider a wider therapeutic paradigm may also have relevance for clients in other health systems.

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Effects of Bariatric Surgery on Cardiovascular Function

Cited by 209 publications

References 140 publications

Obesity paradox in heart failure: a heavy matter

Obesity paradox in heart failure: a heavy matter

Overview of bariatric surgery for the physician

Do We Need A Wider Therapeutic Paradigm For Heart Failure With Comorbidities?: A Remote Australian Perspective

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