Weight reduction regresses left ventricular mass regardless of blood pressure level in obese subjects

Himeno, Etsuro; Nishino, Kimihiro; Nakashima, Yoshiyuki; Kuroiwa, Akio; Ikeda, Masaharu

doi:10.1016/s0002-8703(96)90360-9

Cited by 76 publications

(43 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Substantial weight loss, including BAS, does improve these parameters, but this has not been studied in advanced systolic heart failure. 17 Whereas medical therapy and lifestyle modification have had disappointing long-term results in the treatment of MO, BAS has emerged as an effective treatment option. 18 Safety concerns have limited the use of BAS in patients with advanced CHF, and most BAS studies have excluded such patients.…”

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Ramani

McCloskey

Ramanathan

et al. 2008

Clinical Cardiology

108

View full text Add to dashboard Cite

Background: Morbid obesity (MO) is a risk factor for congestive heart failure (CHF). The presence of MO impairs functional status and disqualifies patients for cardiac transplantation. Bariatric surgery (BAS) is a frontline, durable treatment for MO; however, the safety and efficacy of BAS in advanced CHF is unknown. Hypothesis: We hypothesized that by utilizing a coordinated approach between an experienced surgical team and heart failure specialists, BAS is safe in patients with advanced systolic CHF and results in favorable outcomes. Methods: We performed a retrospective chart review of 12 patients with MO (body mass index [BMI] 53±7 kg/m 2 ) and systolic CHF (left ventricular ejection fraction [LVEF] 22±7%, New York Heart Association [NYHA] class 2.9±0.7) who underwent BAS, and then compared outcomes with 10 matched controls (BMI 47.2±3.6 kg/m 2 , LVEF 24±7%, and NYHA class 2.4±0.7) who were given diet and exercise counseling. Results: At 1 y, hospital readmission in BAS patients was significantly lower than controls (0.4±0.8 versus 2.5±2.6, p = 0.04); LVEF improved significantly in BAS patients (35±15%, p = 0.005), but not in controls (29±14%, p = not significant [NS]). The NYHA class improved in BAS patients (2.3±0.5, p = 0.02), but deteriorated in controls (3.3±0.9, p = 0.02). One BAS patient was successfully transplanted, and another listed for transplantation. Conclusions: Bariatric surgery is safe and effective in patients with MO and severe systolic CHF, and should be considered in patients who have failed conventional therapy to improve clinical status.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Ramani

McCloskey

Ramanathan

et al. 2008

Clinical Cardiology

108

View full text Add to dashboard Cite

show abstract

“…Akt can rescue the small heart phenotype of CIRKO mice. A, Ad-myrAkt1 or Ad-␤-gal (1ϫ10 8 plaqueforming units/animal) was injected into ventricles of newborn CIRKO mice. Ad-␤-gal-injected wild type mice (WT) were used as control.…”

Section: Discussionmentioning

confidence: 99%

“…Heart weight and myocyte fiber size is reduced in starved subjects (5) and in individuals on severe weight loss diets (6). Heart size is markedly reduced in patients with anorexia nervosa (7), and modest weight reduction in normotensive obese subjects is associated with reduced heart size in the absence of changes in blood pressure or other hemodynamic parameters (8). Conversely, heart size is increased in obese subjects without hypertension or other cardiovascular and/or metabolic abnormalities (9).…”

mentioning

confidence: 99%

Akt Signaling Mediates Postnatal Heart Growth in Response to Insulin and Nutritional Status

Shiojima

Yefremashvili

Luo

et al. 2002

Journal of Biological Chemistry

206

182

View full text Add to dashboard Cite

Akt is a serine-threonine kinase that mediates a variety of cellular responses to external stimuli. During postnatal development, Akt signaling in the heart was up-regulated when the heart was rapidly growing and was down-regulated by caloric restriction, suggesting a role of Akt in nutrient-dependent regulation of cardiac growth. Consistent with this notion, reductions in Akt, 70-kDa S6 kinase 1, and eukaryotic initiation factor 4E-binding protein 1 phosphorylation were observed in mice with cardiac-specific deletion of insulin receptor gene, which exhibit a small heart phenotype. In contrast to wild type animals, caloric restriction in these mice had little effect on Akt phosphorylation in the heart. Furthermore, forced expression of Akt1 in these hearts restored 70-kDa S6 kinase 1 and eukaryotic initiation factor 4E-binding protein 1 phosphorylation to normal levels and rescued the small heart phenotype. Collectively, these results indicate that Akt signaling mediates insulin-dependent physiological heart growth during postnatal development and suggest a mechanism by which heart size is coordinated with overall body size as the nutritional status of the organism is varied.

show abstract

“…A redução de peso pode levar a regressão da massa ventricular esquerda independentemente da melhora dos níveis de pressão arterial (104). Em vários estudos, a massa ventricular esquerda correlacionou-se com a perda de peso, mas não com variações da freqüência cardíaca ou da pressão arterial (88,104).…”

Section: Ausência De Doença Pulmonar Vascular Ou Parenquimatosa (19)unclassified

“…Em vários estudos, a massa ventricular esquerda correlacionou-se com a perda de peso, mas não com variações da freqüência cardíaca ou da pressão arterial (88,104).…”

Section: Ausência De Doença Pulmonar Vascular Ou Parenquimatosa (19)unclassified

Obstáculos diagnósticos e desafios terapêuticos no paciente obeso

Mancini

2001

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

Arq Bras Endocrinol Metab vol 45 nº 6 Dezembro 2001 584 RESUMO RESUMOObesidade é uma doença complexa, de múltiplas etiologias e suficientemente comum para constituir um problema de saúde pública, assim como um dilema clínico importante. Especialistas da área clínica e cirúrgica são freqüentemente desafiados pelas alterações fisiopatológicas associadas com a obesidade. Essas alterações comprometem virtualmente todos os sistemas do organismo, podendo apresentar-se como barreiras no diagnósti-co e na terapêutica. Há evidências marcantes de que obesidade acarreta risco excessivo para a saúde; de fato, a mortalidade aumenta de forma aguda quando o índice de massa corporal ultrapassa 30 kg/m 2 , principalmente quando há distribuição central de tecido adiposo concomitante. O autor discute os efeitos da obesidade nos sistemas respitatório, cardiovascular, digestório e geniturinário. Os obstáculos enfrentados em procedimentos diagnósticos ordinários, prescrição de medicamentos, traumas, assim como descrições patológicas raras de lipomas, são apresentados. ABSTRACT ABSTRACTObesity is a complex and multifactorial disease, common enough to constitute a serious medical and public health problem. Medical and surgical specialists are often challenged by pathophysiological changes associated with obesity. These changes, that compromise virtually all organ systems, may constitute barriers to the progress in diagnosis and therapeutics. There is overwhelming evidence that obesity carries excess risk; in fact, mortality rises sharply when body mass index surpasses 30 kg/m 2 , particularly with concomitant central distribution of adipose tissue. The author discusses the effect of obesity on respiratory, cardiovascular, digestive and genitourinary systems. The obstacles faced by physicians in common diagnostic procedures, drug prescription, traumatic injuries, as well as rare pathologic reports of lipomas, are presented.

show abstract

Weight reduction regresses left ventricular mass regardless of blood pressure level in obese subjects

Cited by 76 publications

References 35 publications

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Safety and Efficacy of Bariatric Surgery in Morbidly Obese Patients with Severe Systolic Heart Failure

Akt Signaling Mediates Postnatal Heart Growth in Response to Insulin and Nutritional Status

Obstáculos diagnósticos e desafios terapêuticos no paciente obeso

Contact Info

Product

Resources

About