Morbid Obesity as a Therapeutic Target for Heart Failure

Albert, Chonyang L.

doi:10.1007/s11936-019-0754-z

Cited by 8 publications

(6 citation statements)

References 46 publications

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“…The BMI of the patients with obesity after LSG decreased significantly from 41.6 ± 7.44 to 30.3 ± 5.73kg/m 2 (P<0.001). 11 patients had hypertension (HTN) diagnoses 3 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] years before the LSG, 8 of which have taken the antihypertensive drugs. The proportion of subjects who had taken the antihypertensive drugs would be reduced (18.2 to 6.8%, P<0.05) and the types of antihypertensive drugs also reduced (2.5 [1][2][3][4][5] to 0 [0-3], P<0.05) after LSG.…”

Section: Resultsmentioning

confidence: 99%

“…Bariatric surgery is the only sustained and effective treatment for obesity as a surgical pattern (6). It has been proved that weight loss by bariatric surgery such as laparoscopic sleeve gastrectomy (LSG) could significantly improve the energy metabolism of the patients with obesity, reduce their cardiac lipotoxicity, and play a more extensive role than simply losing weight, so as to ameliorate the cardiac structure and function (5,7). However, the study of the effect of weight loss after LSG on the cardiac is not yet available in the Chinese population, and this protocol is to study the effects of LSG on the cardiac structure and function in obese Chinese.…”

Section: Introductionmentioning

confidence: 99%

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Weight Loss After Laparoscopic Sleeve Gastrectomy Ameliorates the Cardiac Remodeling in Obese Chinese

Meng

Peng

et al. 2022

Front. Endocrinol.

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This study aimed to investigate the impact of weight loss after laparoscopic sleeve gastrectomy (LSG) on cardiac structural and functional remodeling in obese Chinese. A total of 44 obese participants were enrolled consecutively. The physical, laboratory, electrocardiographic, and echocardiographic parameters of pre-and postoperative were recorded. The average follow-up time was 12.28 ± 5.80 months. The body mass index (BMI) of the patients with obesity was decreased from 41.6 ± 7.44 to 30.3 ± 5.73kg/m2 (P<0.001) after LSG. The systolic and diastolic blood pressure of the subjects was significantly reduced from 137.9 ± 15.7mmHg to 123.0 ± 16.0 and 83.4 ± 10.8 to 71.3 ± 11.7mmHg (P<0.001), respectively. The levels of fasting insulin and fasting blood glucose were significantly decreased (38.8 ± 32.1 to 8.43 ± 4.16 mU/L, P<0.001; 6.95 ± 2.59 to 4.64 ± 0.50mmol/L, P<0.001). Total cholesterol (TC, 4.66 ± 0.84 to 4.23 ± 0.75mmol/L, P<0.001) and triglyceride (TG, 1.92 ± 1.21 to 0.85 ± 0.30mmol/L, P<0.001) decreased significantly. Cardiovascular geometric parameters including aortic sinus diameter (ASD, 32.9 ± 2.83mm to 32.0 ± 3.10mm, P<0.05), left atrial diameter (LAD, 38.8 ± 4.03 to 36.2 ± 4.12mm, P<0.001), and interventricular septum thickness(IVS, 10.2 ± 0.93 to 9.64 ± 0.89mm, P<0.001) were significantly reduced. The ratio of weight loss (RWL) was positively correlated with the changes of LAD. The change of IVS was negatively correlated with the change of fasting blood glucose (GLU). Weight loss after LSG could effectively improve cardiac structural, but not functional, abnormality in obese Chinese.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Weight Loss After Laparoscopic Sleeve Gastrectomy Ameliorates the Cardiac Remodeling in Obese Chinese

Meng

Peng

et al. 2022

Front. Endocrinol.

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“…The benefits of BMS for high-risk patients, who suffer from diseases like end-stage heart failure, have to be discussed. According to Albert [6], while morbidity and mortality rates following cardiac surgery or heart transplantation are increased in obese subjects, BMS has been shown to reduce cardiovascular risk factors including diabetes, hypertension, and dyslipidemia. In addition, BMS may even prevent the need for LVAD implantation or a heart transplantation and may serve as a bridging treatment offering heart transplant eligibility in patients with advanced heart failure [6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

et al. 2021

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Bariatric and metabolic surgery is currently the most effective procedure of achieving and maintaining weight loss. In the case under discussion, a 48-year-old male patient with heart insufficiency and an implanted left-ventricular assist device (LVAD) wanted to reduce his high BMI (48.6 kg/m2), so as to qualify for the heart transplant waiting list. According to the guidelines, he underwent all the required preoperative testing, which included psychosomatic clarifications, determination of endocrinological causes, and a nutritional consultation. During laparoscopic sleeve gastrectomy, a cardiac technician was present to support the anesthetist. After inserting 3 trocars with no complications, the greater curvature was mobilized using Medtronic’s bipolar electrothermal vessel-sealing instrument, LigaSure™. The resection was performed with an Ethicon™ endostapler. Postoperative monitoring showed no signs of hemorrhage. The patient’s BMI on the day of surgery was 46.8 kg/m2 and consecutively fell to 26.7 kg/m2 1 year after the procedure. Follow-up appointments revealed that the patient was fit and in good health. Thus, the patient’s aim of being listed on the transplant list was fulfilled, and at the time of this writing, he is ready to be matched with an organ donor. Because high-BMI patients with inserted LVADs are less likely to receive a donor graft and must remain longer on transplant waiting lists than normal-weight patients, bariatric and metabolic weight loss surgery may lead to a speedier resolution for these high-risk patients.

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“…Morbid obesity is used to describe individuals with a body mass index (BMI) of 40 kg/m 2 or greater or a BMI of 35 kg/m 2 or greater with obesity-related health conditions. 3) Obesity can be classified as a primary disease because the adipocyte hypertrophy alters the secretion of hormones that can lead to the dysregulation of metabolic pathways and results in a pro-inflammatory status. The hormones produced by adipocytes are called adipokines and dysregulation of adipokines contributes to development of cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

Differences in Leukocyte Transcriptomes of Morbidly Obese Patients With High Output Heart Failure: A Pilot Study

Cintron,

Pierce,

Sardiu

et al. 2023

Int J Heart Fail

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Background and Objectives Heart failure is characterized by alterations of gene expression that provide insight into the underlying pathophysiologic mechanisms. However, obesity-related high output heart failure (HOHF) is a specific phenotype of heart failure that has not been studied using gene expression. Our aim in this study was to examine the variances in leukocyte transcriptomes of morbidly obese patients with HOHF. Methods In this cross-sectional study, we applied stranded total RNA-sequencing to six patients with morbid obesity and HOHF and 6 patients with morbid obesity and non-HOHF. Differential gene expression was calculated, and Ingenuity Pathway Analysis software was used to interpret the canonical pathways, functional changes, upstream regulators, and networks in these patients. Results We found in patients with HOHF that there were 116 differentially expressed genes with upregulation of 114 genes and downregulation of 2 genes. The differentially expressed genes were involved with cell proliferation, mitochondrial function, erythropoiesis, erythrocyte stability, and apoptosis. The top upregulated canonical pathways associated with differentially expressed genes were autophagy, adenosine monophosphate-activated protein kinase signaling, and senescence pathways. We identified GATA binding protein 1 as an upstream regulator and nuclear factor kappa-light-chain-enhancer of activated B cells associated network. Conclusions We are the first to report the differential gene expression in patients with obesity-related HOHF and reveal the various pathophysiologic mechanisms underlying the disease. Further research is needed to determine the role of cellular function and maintenance, inflammation, and iron homeostasis in obesity-related HOHF.

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Morbid Obesity as a Therapeutic Target for Heart Failure

Cited by 8 publications

References 46 publications

Weight Loss After Laparoscopic Sleeve Gastrectomy Ameliorates the Cardiac Remodeling in Obese Chinese

Weight Loss After Laparoscopic Sleeve Gastrectomy Ameliorates the Cardiac Remodeling in Obese Chinese

Bariatric Surgery as the One Route to Achieving Donor Heart Transplantation in a Patient with a Left-Ventricular Assist Device

Differences in Leukocyte Transcriptomes of Morbidly Obese Patients With High Output Heart Failure: A Pilot Study

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