Left ventricular myocardial oxygen demand and subclinical dysfunction in patients with severe obesity referred for bariatric surgery.
Background and Aims: Increased myocardial oxygen (O2) demand carries higher cardiovascular risk in hypertension. We hypothesized that myocardial O2 demand is increased in severe obesity and linked to early left ventricular (LV) dysfunction.Methods and Results: Baseline data from 106 severely obese s...
| Publicado en: | Nutrition, Metabolism & Cardiovascular Diseases Vol. 31; no. 2; pp. 666 - 675 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Feb2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148727135&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148727135 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09394753 1F3L jtl: Nutrition, Metabolism & Cardiovascular Diseases issn: 09394753 maglogo: N pubinfo: dt: Feb2021 vid: 31 iid: 2 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 148727135 148727135 NLM33257189 148727135 10.1016/j.numecd.2020.10.009 NLM33257189 148727135 ppf: 666 ppct: 9 formats: tig: atl: Left ventricular myocardial oxygen demand and subclinical dysfunction in patients with severe obesity referred for bariatric surgery. aug: au: Grymyr, Lisa M.D. Nadirpour, Saied Gerdts, Eva Nedrebø, Bjørn G. Hjertaas, Johannes J. Matre, Knut Cramariuc, Dana affil: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway sug: subj: Ventricular Function, Left Oxygen Consumption Myocardium Metabolism Ventricular Dysfunction, Left Etiology Obesity Complications Bariatric Surgery Ventricular Dysfunction, Left Physiopathology Obesity Surgery Referral and Consultation Prospective Studies Severity of Illness Indices Cross Sectional Studies Obesity Diagnosis Middle Age Adult Ventricular Dysfunction, Left Metabolism Female Norway Male Human Echocardiography Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Background and Aims: Increased myocardial oxygen (O2) demand carries higher cardiovascular risk in hypertension. We hypothesized that myocardial O2 demand is increased in severe obesity and linked to early left ventricular (LV) dysfunction.Methods and Results: Baseline data from 106 severely obese subjects referred for gastric bypass surgery (42 ± 11 years, 74% women, body mass index [BMI] 41.9 ± 4.8 kg/m2, 32% with hypertension) in the prospective FatWest (Bariatric Surgery on the West Coast of Norway) study was used. LV systolic function was assessed by biplane ejection fraction (EF), midwall shortening (MWS) and endocardial global longitudinal strain (GLS), and LV diastolic function by mitral annular early diastolic velocity (e'). Myocardial O2 demand was estimated from the LV mass-wall stress-heart rate product (high if > 1.62 × 106/2.29 × 106 g kdyne/cm2 bpm in women/men). High myocardial O2 demand was found in 33% and associated with higher BMI and high prevalence of low GLS (65%) and low MWS (63%) despite normal EF. In ROC analyses, higher myocardial O2 demand discriminated between patients with low vs. normal MWS and GLS (area under curve 0.71 and 0.63, p < 0.05). In successive multiple regression analyses, higher myocardial O2 demand was associated with lower LV MWS, GLS and average e', respectively, independent of age, gender, BMI, pulse pressure, diabetes mellitus, and EF (all p < 0.05).Conclusion: In obese patients without known heart disease and with normal EF referred for bariatric surgery, high myocardial O2 demand is associated with lower myocardial function whether assessed by GLS or MWS independent of confounders. CLINICALTRIALS.Gov Identifier: NCT01533142. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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