Document Detail


Reversibility of cardiac abnormalities in morbidly obese adolescents.
MedLine Citation:
PMID:  18387434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to evaluate changes in cardiac geometry, systolic and diastolic function before and after weight loss in morbidly obese adolescents. BACKGROUND: Cardiac abnormalities are present in morbidly obese adolescents; however, it is unclear if they are reversible with weight loss. METHODS: Data from 38 adolescents (13 to 19 years; 29 females, 9 males, 33 Caucasians, 5 African Americans) were evaluated before and after bariatric surgery. Left ventricular mass (LVM), left ventricular (LV) geometry, systolic and diastolic function were assessed by echocardiography. Mean follow up was 10 +/- 3 months. RESULTS: Weight and body mass index decreased post-operatively (mean weight loss 59 +/- 15 kg, pre-operative body mass index 60 +/- 9 kg/m(2) vs. follow-up 40 +/- 8 kg/m(2), p < 0.0001). Change in LVM index (54 +/- 13 g/m(2.7) to 42 +/- 10 g/m(2.7), p < 0.0001) correlated with weight loss (r = 0.41, p = 0.01). Prevalence of concentric left ventricular hypertrophy (LVH) improved from 28% at pre-operative to only 3% at follow up (p = 0.007), and normal LV geometry improved from 36% to 79% at follow up (p = 0.009). Diastolic function also improved (mitral E/Ea lateral 7.7 +/- 2.3 at pre-operative vs. 6.3 +/- 1.6 at post-operative, p = 0.003). In addition, rate-pressure product improved suggesting decreased cardiac workload (p < 0.001). CONCLUSIONS: Elevated LVM index, concentric LVH, altered diastolic function, and cardiac workload significantly improve following surgically induced weight loss in morbidly obese adolescents. Large weight loss due to bariatric surgery improves predictors of future cardiovascular morbidity in these young people.
Authors:
Holly M Ippisch; Thomas H Inge; Stephen R Daniels; Baiyang Wang; Philip R Khoury; Sandra A Witt; Betty J Glascock; Victor F Garcia; Thomas R Kimball
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  51     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-04     Completed Date:  2008-05-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1342-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Cincinnati Children's Hospital, Medical Center and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45229, USA. Holly.Ippisch@cchmc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bariatric Surgery*
Body Mass Index
Diastole
Disease Progression
Female
Heart / physiopathology*
Heart Diseases / etiology*,  physiopathology,  prevention & control*
Humans
Hypertrophy, Left Ventricular / etiology,  physiopathology
Male
Obesity, Morbid / complications*,  physiopathology,  surgery
Prevalence
Systole
Weight Loss*
Grant Support
ID/Acronym/Agency:
T32-ES10957/ES/NIEHS NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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