Obesity and cardiology

Abstract

Introduction: Morbid obesity is associated with a number of ventilatory and cardiovascular disorders and increased risk for cardiovascular diseases, which can be improved by weight loss. Cardiopulmonary testing (CPET) is proposed for the objective evaluation of the effects of bariatric surgery in morbid obese patients. Aim: To evaluate the change of CPET and hemodynamic parameters in patients treated with bariatric surgery. Methods: We performed CPET in 250 morbid obese patients during for the preoperative assessment. We analyzed 50 patients (37 women, mean age 38±10 years) before and 6 months after bariatric surgery. All patients underwent CPET (treadmill, Bruce protocol) with expiratory gas analyses. Results: The mean weight before treatment was 126.69 ±19.21kg, and BMI was 43.8 ± 5.4 kg/m2. Averaged body weight reduction was -29, 6 kg, and BMI -10 kg/m2 after 6 months follow-up, with significant difference in comparison to baseline values (43.8±5, 4 vs 33.9±14, 3; p<0.0001). CPET parameters showed increase in VO2 at ventilatory anaerobic threshold (17.86±3.44 vs 20.86±4.70; p<0.0001), Peak VO2 (20.79±3.63 vs 24.97±4.37; p<0.0001) and improvement of ventilatory efficacy VE/VCO2 slope (34.64±4.34 vs 24.74±3.39; p<0.0001), and PetCO confirming the improvement of cardiopulmonary function. Hemodynamic parameters were also improved with decrease in resting heart rate (p<0.0001), resting and peak systolic (p<0.0001) and diastolic blood pressure (p<0.0001 and p=0.002). Conclusion: These results show significant relationship between weight loss and improvement of anaerobic capacity after bariatric treatment. CPET is shown to be a valuable and reliable tool for the objective assessment of functional improvement.

Keywords

• morbid obesity
• bariatric surgery
• cardiopulmonary test