Xiao-Yan Jia, Rui-Jia Lian, Bao-Dong Ma, Yang-Xi Hu, Qin-Jun Chu, Hai-Yun Jing, Zhi-Qiang Kang, Jian-Ping Ye, Xi-Wen Ma
{"title":"腹腔镜下袖胃切除术对肥胖心力衰竭患者心脏结构和功能的影响。","authors":"Xiao-Yan Jia, Rui-Jia Lian, Bao-Dong Ma, Yang-Xi Hu, Qin-Jun Chu, Hai-Yun Jing, Zhi-Qiang Kang, Jian-Ping Ye, Xi-Wen Ma","doi":"10.3881/j.issn.1000-503X.16179","DOIUrl":null,"url":null,"abstract":"<p><p>Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(<i>n</i>=17),a HF with mildly reduced ejection fraction group(<i>n</i>=5)and a HF with reduced ejection fraction(HFrEF)group(<i>n</i>=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples <i>t</i>-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m<sup>2</sup>.The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(<i>P</i>=0.002),body surface area(BSA)(<i>P</i>=0.009),waist circumference(<i>P</i>=0.010),hip circumference(<i>P</i>=0.031),body fat content(<i>P</i>=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(<i>P</i><0.001)decreased.At the 12-month follow-up left atrial diameter(<i>P</i>=0.006),right atrial long-axis inner diameter(RAD1)(<i>P</i><0.001),right atrial short-axis inner diameter(RAD2)(<i>P</i><0.001),right ventricular inner diameter(<i>P</i>=0.002),interventricular septal thickness at end-diastolic(<i>P</i>=0.002),and left ventricular end-diastolic volumes(<i>P</i>=0.004)and left ventricular end-systolic volumes(<i>P</i>=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both <i>P</i><0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(<i>P</i>=0.003),left ventricular inner diameter at end-diastole(<i>P</i>=0.008),RAD1(<i>P</i><0.001),RAD2(<i>P</i>=0.004),right ventricular inner diameter(<i>P</i>=0.019),left ventricular end-diastolic volume(<i>P</i>=0.004)and left ventricular end-systolic volume(<i>P</i>=0.001),cardiac output(<i>P</i>=0.006),tricuspid regurgitation velocity(<i>P</i>=0.002),and pulmonary artery systolic pressure(<i>P</i>=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(<i>P</i><0.001,<i>P</i>=0.003,<i>P</i><0.001)and LVEF(<i>P</i><0.001,<i>P</i>=0.011,<i>P</i>=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 2","pages":"226-236"},"PeriodicalIF":0.0000,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Laparoscopic Sleeve Gastrectomy on Cardiac Structure and Function in Obese Patients With Heart Failure.\",\"authors\":\"Xiao-Yan Jia, Rui-Jia Lian, Bao-Dong Ma, Yang-Xi Hu, Qin-Jun Chu, Hai-Yun Jing, Zhi-Qiang Kang, Jian-Ping Ye, Xi-Wen Ma\",\"doi\":\"10.3881/j.issn.1000-503X.16179\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(<i>n</i>=17),a HF with mildly reduced ejection fraction group(<i>n</i>=5)and a HF with reduced ejection fraction(HFrEF)group(<i>n</i>=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples <i>t</i>-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m<sup>2</sup>.The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(<i>P</i>=0.002),body surface area(BSA)(<i>P</i>=0.009),waist circumference(<i>P</i>=0.010),hip circumference(<i>P</i>=0.031),body fat content(<i>P</i>=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(<i>P</i><0.001)decreased.At the 12-month follow-up left atrial diameter(<i>P</i>=0.006),right atrial long-axis inner diameter(RAD1)(<i>P</i><0.001),right atrial short-axis inner diameter(RAD2)(<i>P</i><0.001),right ventricular inner diameter(<i>P</i>=0.002),interventricular septal thickness at end-diastolic(<i>P</i>=0.002),and left ventricular end-diastolic volumes(<i>P</i>=0.004)and left ventricular end-systolic volumes(<i>P</i>=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both <i>P</i><0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(<i>P</i>=0.003),left ventricular inner diameter at end-diastole(<i>P</i>=0.008),RAD1(<i>P</i><0.001),RAD2(<i>P</i>=0.004),right ventricular inner diameter(<i>P</i>=0.019),left ventricular end-diastolic volume(<i>P</i>=0.004)and left ventricular end-systolic volume(<i>P</i>=0.001),cardiac output(<i>P</i>=0.006),tricuspid regurgitation velocity(<i>P</i>=0.002),and pulmonary artery systolic pressure(<i>P</i>=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(<i>P</i><0.001,<i>P</i>=0.003,<i>P</i><0.001)and LVEF(<i>P</i><0.001,<i>P</i>=0.011,<i>P</i>=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.</p>\",\"PeriodicalId\":6919,\"journal\":{\"name\":\"中国医学科学院学报\",\"volume\":\"47 2\",\"pages\":\"226-236\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中国医学科学院学报\",\"FirstCategoryId\":\"1087\",\"ListUrlMain\":\"https://doi.org/10.3881/j.issn.1000-503X.16179\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国医学科学院学报","FirstCategoryId":"1087","ListUrlMain":"https://doi.org/10.3881/j.issn.1000-503X.16179","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Effects of Laparoscopic Sleeve Gastrectomy on Cardiac Structure and Function in Obese Patients With Heart Failure.
Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(n=17),a HF with mildly reduced ejection fraction group(n=5)and a HF with reduced ejection fraction(HFrEF)group(n=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples t-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m2.The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(P=0.002),body surface area(BSA)(P=0.009),waist circumference(P=0.010),hip circumference(P=0.031),body fat content(P=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(P<0.001)decreased.At the 12-month follow-up left atrial diameter(P=0.006),right atrial long-axis inner diameter(RAD1)(P<0.001),right atrial short-axis inner diameter(RAD2)(P<0.001),right ventricular inner diameter(P=0.002),interventricular septal thickness at end-diastolic(P=0.002),and left ventricular end-diastolic volumes(P=0.004)and left ventricular end-systolic volumes(P=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both P<0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(P=0.003),left ventricular inner diameter at end-diastole(P=0.008),RAD1(P<0.001),RAD2(P=0.004),right ventricular inner diameter(P=0.019),left ventricular end-diastolic volume(P=0.004)and left ventricular end-systolic volume(P=0.001),cardiac output(P=0.006),tricuspid regurgitation velocity(P=0.002),and pulmonary artery systolic pressure(P=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(P<0.001,P=0.003,P<0.001)and LVEF(P<0.001,P=0.011,P=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.
期刊介绍：
Acta Academiae Medicinae Sinicae was founded in February 1979. It is a comprehensive medical academic journal published in China and abroad, supervised by the Ministry of Health of the People's Republic of China and sponsored by the Chinese Academy of Medical Sciences and Peking Union Medical College.
The journal mainly reports the latest research results, work progress and dynamics in the fields of basic medicine, clinical medicine, pharmacy, preventive medicine, biomedicine, medical teaching and research, aiming to promote the exchange of medical information and improve the academic level of medicine. At present, the journal has been included in 10 famous foreign retrieval systems and their databases [Medline (PubMed online version), Elsevier, EMBASE, CA, WPRIM, ExtraMED, IC, JST, UPD and EBSCO-ASP]; and has been included in important domestic retrieval systems and databases [China Science Citation Database (Documentation and Information Center of the Chinese Academy of Sciences), China Core Journals Overview (Peking University Library), China Science and Technology Paper Statistical Source Database (China Science and Technology Core Journals) (China Institute of Scientific and Technological Information), China Science and Technology Journal Paper and Citation Database (China Institute of Scientific and Technological Information)].
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