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Austin MA, Ahmad D, Rosen JL, Weber MP, Rajapreyar I, Rame JE, Alvarez RJ, Entwistle JW, Massey HT, Tchantchaleishvili V. Impact of waitlist weight change on outcomes in heart transplant recipients: a UNOS database analysis. Gen Thorac Cardiovasc Surg 2025; 73:336-342. [PMID: 39361224 PMCID: PMC11993457 DOI: 10.1007/s11748-024-02078-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 08/27/2024] [Indexed: 04/13/2025]
Abstract
BACKGROUND While the effect of pre-transplant weight on patient outcomes following heart transplantation (HTx) has previously been studied, data regarding the impact of dynamic weight change prior to HTx are extremely limited. OBJECTIVES We sought to elucidate the interaction between HTx listing weight and weight change while waitlisted, and explore how that interaction impacts post-HTx survival in a continuous manner. METHODS Adult patients listed for HTx from 1987 to 2020 were identified from UNOS database. Three-dimensional restricted cubic spline analysis explored post-HTx survival relative to both changes in BMI/weight and BMI at time of HTx listing. Continuous predictor variables were analyzed with Cox proportional hazards method. RESULTS 9,628 included patients underwent HTx. Median recipient age was 55 [IQR 46-62] years, and 21% were females. 53% of patients lost while 47% gained weight on the waitlist. Median BMI (27.6 kg/m2 [24.3-31.3] vs. 27.4 kg/m2 [24.2-30.9], paired p < 0.001) and weight (84.8 kg [73.0-98.0] kg vs. 84.4 kg [72.6-96.6], p < 0.001) were similar at listing and transplant. One-year survival was 89.3%. Weight loss over 3 BMI points or 10 kg was associated with higher hazard of death irrespective of listing BMI. In non-obese patients, some weight gain (1-4 BMI points or 5-15 kg) was associated with improved survival. In cachectic patients (BMI < 18.5), failure to gain weight was associated with worse survival. CONCLUSIONS Impact of weight change varies depending on listing BMI. While a survival benefit is seen in non-obese patients who gain some weight, significant weight loss is associated with poorer survival.
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Affiliation(s)
- Melissa A Austin
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA
| | - Danial Ahmad
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA
| | - Jake L Rosen
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA
| | - Matthew P Weber
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA
| | | | - Jesus Eduardo Rame
- Division of Cardiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Rene J Alvarez
- Division of Cardiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - John W Entwistle
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA
| | - Howard T Massey
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA
| | - Vakhtang Tchantchaleishvili
- Division of Cardiac Surgery, Thomas Jefferson University, 1025 Walnut Street, College Building, Suite 607, Philadelphia, PA, 19107, USA.
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Pouwels S, Thaher O, Vladimirov M, Felsenreich DM, Pascotto B, Taha S, Bausch D, Oviedo RJ. Global collaborative research in metabolic and bariatric surgery (GCRMBS): current status and directions for the future. BMC Surg 2024; 24:367. [PMID: 39563353 PMCID: PMC11577625 DOI: 10.1186/s12893-024-02636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 10/15/2024] [Indexed: 11/21/2024] Open
Abstract
Obesity has been recognized as a chronic disorder by the World Health Organisation (WHO) and was first reported in the Paleolithic age. In the recent years there has not been an international collaborative that facilitates professional cooperation on a worldwide level to increase the output of high-level evidence in the fields of obesity treatment and metabolic and bariatric surgery (MBS). In other surgical and medical fields, international collaborative research networks have shown to increase the quality and amount of treatment-changing evidence. In general, Global Collaborative Research in MBS (GCRMBS) should have the following goals: (1) clinical specialty-based research in obesity and MBS, (2) designing research protocols and studies to generate long-term data in obesity and MBS, (3) understanding the uncommon/rare complications and events associated with obesity and MBS, (4) increasing the number of participants in research and (5) investigating ethical and racial disparities in bariatric research. This review gives an overview of the current status and the future of international collaborative research in MBS.
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Affiliation(s)
- Sjaak Pouwels
- Department of Surgery, Marien Hospital Herne, University Hospital of Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, NRW, Germany.
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
| | - Omar Thaher
- Department of Surgery, Marien Hospital Herne, University Hospital of Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, NRW, Germany
| | - Miljana Vladimirov
- Department of Surgery, University of Bielefeld - Campus Detmold, Detmold, NRW, Germany
| | | | - Beniamino Pascotto
- Department of General and Minimally Invasive Surgery, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Safwan Taha
- Department of Metabolic and Bariatric Surgery, Mediclinic Airport Road Hospital, Abu Dhabi, United Arab Emirates
| | - Dirk Bausch
- Department of Surgery, Marien Hospital Herne, University Hospital of Ruhr University Bochum, Hölkeskampring 40, 44625, Herne, NRW, Germany
| | - Rodolfo J Oviedo
- Nacogdoches Medical Center, Nacogdoches, TX, USA
- University of Houston Tilman J. Fertitta Family College of Medicine, Houston, TX, USA
- Sam Houston State University College of Osteopathic Medicine, Conroe, TX, USA
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Tsai C, Dolan P, Moss N, Sandoval AF, Roldan J, Herron DM. Sleeve gastrectomy facilitates weight loss and permits cardiac transplantation in patients with severe obesity and a left ventricular assist device (LVAD). Surg Endosc 2023; 37:8655-8662. [PMID: 37495848 DOI: 10.1007/s00464-023-10264-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/27/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION Patients suffering from advanced heart failure may undergo left ventricular assist device (LVAD) placement as a bridge to cardiac transplantation. However, those with a BMI above 35 kg/m2 are generally not considered eligible for transplant due to their elevated cardiac risk. We review our experience with bariatric surgery in this high-risk population to assess its safety and efficacy in reducing BMI to permit cardiac transplantation. METHODS We retrospectively reviewed all patients on durable LVAD support who underwent sleeve gastrectomy (SG) at Mount Sinai Hospital between August 2018 and December 2022. Electronic medical records were reviewed to analyze patient demographics, surgical details, and outcomes regarding weight loss and heart transplantation. RESULTS We identified twelve LVAD patients who underwent SG. Three were performed laparoscopically and 9 via robotic approach. Four patients (33.3%) underwent an orthotopic heart transplant (OHTx). Half of these patients were female. For patients who underwent OHTx, mean age at LVAD placement was 41.0 (R30.6-52.2), at SG was 43.9 (R32.7-55.0) and at OHTx was 45.3 years (R33.3-56.8). Mean BMI increased from 38.8 at LVAD placement to 42.5 prior to SG. Mean time from SG to OHTx was 17.9 months (R6-7-27.5) during which BMI decreased to mean 32.8 at the time of OHTx. At most recent follow-up, mean BMI was 31.9. All patients were anticoagulated prior to surgery; one required return to the operating room on post-operative day 1 after SG for bleeding and one was re-admitted on post-operative day 7 for hematochezia treated conservatively. CONCLUSION SG is a safe and effective operation in patients with severe obesity and heart failure requiring an LVAD. 66.7% of our cohort achieved target BMI < 35 and 33.3% underwent heart transplantation. Longer term follow-up is needed to clarify full bridge-to-transplant rate and long-term survival outcomes.
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Affiliation(s)
- Catherine Tsai
- Department of Surgery, Mount Sinai Health System, 1 Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Patrick Dolan
- Department of Surgery, Mount Sinai Health System, 1 Gustave L. Levy Place, New York, NY, 10029, USA
| | - Noah Moss
- Department of Cardiology, Mount Sinai Health System, New York, USA
| | | | - Julie Roldan
- Department of Cardiology, Mount Sinai Health System, New York, USA
| | - Daniel M Herron
- Department of Surgery, Mount Sinai Health System, 1 Gustave L. Levy Place, New York, NY, 10029, USA
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Potrykus M, Czaja-Stolc S, Małgorzewicz S, Proczko-Stepaniak M, Dębska-Ślizień A. Diet Management of Patients with Chronic Kidney Disease in Bariatric Surgery. Nutrients 2022; 15:nu15010165. [PMID: 36615822 PMCID: PMC9824280 DOI: 10.3390/nu15010165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 12/31/2022] Open
Abstract
Morbid obesity is considered a civilization disease of the 21st century. Not only does obesity increase mortality, but it is also the most important cause of the shortening life expectancy in the modern world. Obesity is associated with many metabolic abnormalities: dyslipidemia, hyperglycemia, cardiovascular diseases, and others. An increasing number of patients diagnosed with chronic kidney disease (CKD) are obese. Numerous additional disorders associated with impaired kidney function make it difficult to conduct slimming therapy and may also be associated with a greater number of complications than in people with normal kidney function. Currently available treatments for obesity include lifestyle modification, pharmacotherapy, and bariatric surgery (BS). There are no precise recommendations on how to reduce excess body weight in patients with CKD treated conservatively, undergoing chronic dialysis, or after kidney transplantation. The aim of this study was to analyze studies on the bariatric treatment of obesity in this group of people, as well as to compare the recommendations typical for bariatrics and CKD.
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Affiliation(s)
- Marta Potrykus
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-211 Gdańsk, Poland
| | - Sylwia Czaja-Stolc
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland
- Correspondence: ; Tel.: +48-(58)-349-27-24
| | - Sylwia Małgorzewicz
- Department of Clinical Nutrition, Medical University of Gdansk, 80-211 Gdańsk, Poland
| | - Monika Proczko-Stepaniak
- Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-211 Gdańsk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdansk, 80-952 Gdańsk, Poland
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Scheibe CL, Pinto LEV, Valadão JA, de Oliveira CMB, Moura ECR, Campelo GP, de Lima RC, Freire TT, de Oliveira EJSG, da Cunha Leal P. Laparoscopic Bypass in Morbidly Obese Patient with End-Stage Heart Failure: Case Report. Obes Surg 2021; 31:5059-5062. [PMID: 34212344 DOI: 10.1007/s11695-021-05549-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 11/25/2022]
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daSilva-deAbreu A, Alhafez BA, Curbelo-Pena Y, Lavie CJ, Ventura HO, Loro-Ferrer JF, Mandras SA. Bariatric Surgery in Patients with Obesity and Ventricular Assist Devices Considered for Heart Transplantation: Systematic Review and Individual Participant Data Meta-analysis. J Card Fail 2021; 27:338-348. [PMID: 33358959 DOI: 10.1016/j.cardfail.2020.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Class II obesity (body mass index BMI ≥35 kg/m2) is a contraindication to heart transplantation (HT). Although few single-center studies (case reports/series and small cohorts) have reported promising outcomes of bariatric surgery (BS) in patients with obesity and ventricular assist devices, low sample sizes have made their analysis and interpretation challenging. METHODS AND RESULTS We conducted a systematic search in ClinicalTrials.gov, Cochrane, Embase, PubMed, Google Scholar, and most relevant bariatric and heart failure journals. We extracted baseline and outcome individual participant data for every ventricular assist device patient undergoing BS with reported postoperative BMI and their respective timepoints when BMI data were measured. Fourteen references with 29 patients were included. The mean age was 41.9 ± 12.2 years, 82.8% underwent laparoscopic sleeve gastrectomy, and 39.3% had reported perioperative adverse events. The mean pre-BS BMI was 45.5 ± 6.6 kg/m2 and decreased significantly during follow-up (rho -0.671; P< .00001). Among 23 patients with documented listing status, 78.3% were listed for HT. Thirteen of 28 patients (46.4%) underwent HT at 14.4 ± 7.0 months. There were no reported deaths for the HT-free 1-year period. Median follow-up was 24 months (interquartile range, 12-30 months). Twenty-two of 28 patients (78.6%) achieved the composite outcome (BMI of<35 kg/m2/HT/listing for HT/myocardial recovery) at 11 months (interquartile range, 3-17 months). Patients with a BMI<45 kg/m2 had a higher chance of achieving the composite outcome (P< .003). CONCLUSIONS BS may help patients with obesity and ventricular assist devices to lose a significant amount of weight and improve their candidacy for HT or even achieve myocardial recovery.
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Affiliation(s)
- Adrian daSilva-deAbreu
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland Ochsner Clinical School, New Orleans, Louisiana; Doctoral School, Universidad de Las Palmas de Gran Canaria, Las Palmas, Spain.
| | | | - Yuhamy Curbelo-Pena
- Service of General Surgery, Consorci Sanitari de l'Alt Penedes i Garraf, Barcelona, Spain
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland Ochsner Clinical School, New Orleans, Louisiana
| | - Hector O Ventura
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland Ochsner Clinical School, New Orleans, Louisiana
| | | | - Stacy A Mandras
- John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, Louisiana; The University of Queensland Ochsner Clinical School, New Orleans, Louisiana
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Clinical Outcomes, Trends in Weight, and Weight Loss Strategies in Patients With Obesity After Durable Ventricular Assist Device Implantation. Curr Heart Fail Rep 2021; 18:52-63. [PMID: 33420916 DOI: 10.1007/s11897-020-00500-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW To discuss clinical outcomes, changes in weight, and weight loss strategies of patients with obesity post left ventricular assist device (LVAD) implantation. RECENT FINDINGS Despite increased complications in patients with obesity after LVAD implantation, survival is comparable to patients without obesity. A minority of patients with obesity lose significant weight and become eligible for heart transplantation after LVAD implantation. In fact, a great majority of such patients gain weight post-implantation. Obesity by itself should not be considered prohibitive for LVAD therapy but, rather, should be incorporated into the overall risk assessment for LVAD implantation. Concerted strategies should be developed to promote sustainable weight loss in patients with obesity and LVAD to improve quality of life, eligibility, and outcomes after heart transplantation. Investigation of the long-term impact of weight loss on patients with obesity with LVAD is warranted.
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8
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Orandi BJ, Purvis JW, Cannon RM, Smith AB, Lewis CE, Terrault NA, Locke JE. Bariatric surgery to achieve transplant in end-stage organ disease patients: A systematic review and meta-analysis. Am J Surg 2020; 220:566-579. [PMID: 32600846 PMCID: PMC7484004 DOI: 10.1016/j.amjsurg.2020.04.041] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND As obesity prevalence grows, more end-stage organ disease patients will be precluded from transplant. Numerous reports suggest bariatric surgery in end-stage organ disease may help patients achieve weight loss sufficient for transplant listing. METHODS We performed a systematic review/meta-analysis of studies of bariatric surgery to achieve solid organ transplant listing. RESULTS Among 82 heart failure patients, 40.2% lost sufficient weight for listing, 29.3% were transplanted, and 8.5% had sufficient improvement with weight loss they no longer required transplantation. Among 28 end-stage lung disease patients, 28.6% lost sufficient weight for listing, 7.1% were transplanted, and 14.3% had sufficient improvement following weight loss they no longer required transplant. Among 41 cirrhosis patients, 58.5% lost sufficient weight for listing, 41.5% were transplanted, and 21.9% had sufficient improvement following weight loss they no longer required transplant. Among 288 end-stage/chronic kidney disease patients, 50.3% lost sufficient weight for listing and 29.5% were transplanted. CONCLUSIONS Small sample size and publication bias are limitations; however, bariatric surgery may benefit select end-stage organ disease patients with obesity that precludes transplant candidacy.
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Affiliation(s)
- Babak J Orandi
- University of Alabama at Birmingham Schools of Medicine, Department of Surgery, United States.
| | - Joshua W Purvis
- University of Alabama at Birmingham Schools of Medicine, Department of Surgery, United States
| | - Robert M Cannon
- University of Alabama at Birmingham Schools of Medicine, Department of Surgery, United States
| | - A Blair Smith
- University of Alabama at Birmingham Schools of Medicine, Department of Anesthesia, United States
| | - Cora E Lewis
- University of Alabama at Birmingham Schools of Medicine, Department of Medicine, United States; University of Alabama at Birmingham Schools of Medicine, Public Health, United States
| | - Norah A Terrault
- University of Southern California Keck School of Medicine, Department of Medicine, United States
| | - Jayme E Locke
- University of Alabama at Birmingham Schools of Medicine, Department of Surgery, United States
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Ventricular Assist Device Implantation and Bariatric Surgery: A Route to Transplantation in Morbidly Obese Patients with End-Stage Heart Failure. ASAIO J 2020; 67:163-168. [DOI: 10.1097/mat.0000000000001212] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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10
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Sleeve Gastrectomy in Patients with Continuous-Flow Left Ventricular Assist Devices: a Systematic Review and Meta-Analysis. Obes Surg 2020; 30:4437-4445. [DOI: 10.1007/s11695-020-04834-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 06/28/2020] [Accepted: 07/02/2020] [Indexed: 01/06/2023]
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Van Aelst P, Deleus E, Van der Schueren B, Meyns B, Vandersmissen K, Lannoo M. Laparoscopic Sleeve Gastrectomy in Patients with Left Ventricular Assist Device—Case Series and Review of Literature. Obes Surg 2020; 30:3628-3633. [DOI: 10.1007/s11695-020-04642-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S. Cardiac remodeling in obesity and after bariatric and metabolic surgery; is there a role for gastro-intestinal hormones? Expert Rev Cardiovasc Ther 2019; 17:771-790. [PMID: 31746657 DOI: 10.1080/14779072.2019.1690991] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overview of obesity and cardiovascular remodeling, the individual actions of the gut hormones (like GLP-1 and PYY), the effects after bariatric/metabolic surgery and its influence on cardiac remodeling. In this review, we focussed and searched for literature in Pubmed and The Cochrane library (from the earliest date until April 2019), regarding cardiac function changes before and after bariatric surgery and literature regarding changes in gastrointestinal hormones.Expert opinion: Regarding the surgical treatment of obesity and metabolic diseases there is recognition of the importance of both weight loss (bariatric surgery) and improvement in metabolic milieu (metabolic surgery). A growing body of evidence further suggests that bariatric surgical procedures [like the Sleeve Gastrectomy (SG), Roux-en Y Gastric Bypass (RYGB), or One Anastomosis Gastric Bypass (OAGB)] have can improve outcomes of patients suffering from a number of cardiovascular diseases, including heart failure.
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Affiliation(s)
- Elijah Sanches
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Marieke Timmermans
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Besir Topal
- Department of Cardiothoracic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Alper Celik
- Department of Bariatric and Metabolic Surgery, Metabolic Surgery Clinic, Sisli, Turkey
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Rui Ribeiro
- Centro Multidisciplinar da Doença Metabólica, Clínica de Santo António, Lisbon, Portugal
| | - Chetan Parmar
- Department of Surgery, Whittington Hospital, London, UK
| | - Surendra Ugale
- Bariatric & Metabolic Surgery Clinic, Kirloskar Hospital, Hyderabad, India
| | - Monika Proczko
- Department of General, Endocrine and Transplant Surgery, University Medical Center, Gdansk University, Gdansk, Poland
| | - Pieter S Stepaniak
- Department of Operating Rooms, Catharina Hospital, Eindhoven, The Netherlands
| | | | - Kamal Mahawar
- Bariatric Unit, Sunderland Royal Hospital, Sunderland, UK
| | - Marc P Buise
- Department of Anesthesiology, Intensive Care and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - Aleksandr Neimark
- Department of Surgery, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Rich Severin
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.,Doctor of Physical Therapy Program, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Sjaak Pouwels
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
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Zenilman A, Pechman D, Moran-Atkin E, Choi J, Camacho D. Bariatric surgery in patients with left ventricular assist devices: a safe and effective method of weight loss as a gateway to heart transplantation. Surg Obes Relat Dis 2019; 15:1780-1784. [DOI: 10.1016/j.soard.2019.08.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 07/09/2019] [Accepted: 08/03/2019] [Indexed: 01/11/2023]
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Albert CL. Morbid Obesity as a Therapeutic Target for Heart Failure. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2019; 21:52. [DOI: 10.1007/s11936-019-0754-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Laparoscopic Sleeve Gastrectomy in Heart Failure Patients with Left Ventricular Assist Device. Obes Surg 2019; 29:1122-1129. [DOI: 10.1007/s11695-018-3570-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lee AY, Tecson KM, Lima B, Shaikh AF, Collier J, Still S, Baxter R, DiMaio JM, Felius J, Carey SA, Gonzalez‐Stawinski GV, Nauret R, Wong M, Hall SA, Joseph SM. Durable left ventricular assist device implantation in extremely obese heart failure patients. Artif Organs 2019; 43:234-241. [DOI: 10.1111/aor.13380] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/31/2018] [Accepted: 09/27/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Andy Y. Lee
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
| | | | - Brian Lima
- Department of Cardiovascular and Thoracic Surgery North Shore University Hospital Manhasset NY
| | - Asad F. Shaikh
- Texas A&M College of Medicine Health Science Center Dallas TX
| | - Justin Collier
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
| | - Sasha Still
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
| | - Ronald Baxter
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
| | - John M. DiMaio
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
- The Heart Hospital of Baylor Plano Plano TX
| | - Joost Felius
- Baylor Scott & White Research Institute Dallas TX
| | | | | | - Richard Nauret
- Texas A&M College of Medicine Health Science Center Dallas TX
| | - Marcus Wong
- Texas A&M College of Medicine Health Science Center Dallas TX
| | - Shelley A. Hall
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
| | - Susan M. Joseph
- Baylor University Medical Center, Center for Advanced Heart and Lung Dallas TX
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Laparoscopic sleeve gastrectomy in patients with heart failure and left ventricular assist devices as a bridge to transplant. Surg Obes Relat Dis 2018; 14:1269-1273. [DOI: 10.1016/j.soard.2018.04.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 01/06/2023]
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English WJ, Williams DB. Metabolic and Bariatric Surgery: An Effective Treatment Option for Obesity and Cardiovascular Disease. Prog Cardiovasc Dis 2018; 61:253-269. [PMID: 29953878 DOI: 10.1016/j.pcad.2018.06.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 06/21/2018] [Indexed: 01/07/2023]
Abstract
Obesity is a chronic and debilitating disease that has become a global epidemic. Especially severe in the Unites States, obesity currently affects almost 40% of the population. Obesity has a strong causal relationship with numerous serious comorbidities that impair quality of life, shorten life expectancy, and carry a major economic burden. Obesity has particular relevance to cardiologists because it contributes directly to several major cardiovascular diseases and, consequently, increases overall cardiovascular mortality. Multiple treatment options are available, but metabolic and bariatric surgery offers the most effective and durable treatment for obesity. Moreover, metabolic and bariatric operations alleviate and often completely eliminate numerous comorbidities, particularly type 2 diabetes and other cardiovascular risk factors, such as hypertension and dyslipidemia. With their low risk of complications and morbidity, metabolic and bariatric operations significantly improve quality of life and overall survival, particularly reducing death due to cardiovascular disease.
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Affiliation(s)
- Wayne J English
- Vanderbilt University Medical Center, 1161 21(st) Avenue South, Room D5203 MCN, Nashville, TN 37232-2577, United States of America.
| | - D Brandon Williams
- Vanderbilt University Medical Center, 1161 21(st) Avenue South, Room D5203 MCN, Nashville, TN 37232-2577, United States of America.
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Han J, Mauro CM, Kurlansky PA, Fukuhara S, Yuzefpolskaya M, Topkara VK, Garan AR, Colombo PC, Takayama H, Naka Y, Takeda K. Impact of Obesity on Readmission in Patients With Left Ventricular Assist Devices. Ann Thorac Surg 2018; 105:1192-1198. [DOI: 10.1016/j.athoracsur.2017.10.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/04/2017] [Accepted: 10/16/2017] [Indexed: 11/16/2022]
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Tsamalaidze L, Elli EF. Solid Organ Transplantation and Bariatric Surgery. THE SAGES MANUAL OF BARIATRIC SURGERY 2018:615-633. [DOI: 10.1007/978-3-319-71282-6_45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Rodriguez Flores M, Aguilar Salinas C, Piché ME, Auclair A, Poirier P. Effect of bariatric surgery on heart failure. Expert Rev Cardiovasc Ther 2017; 15:567-579. [PMID: 28714796 DOI: 10.1080/14779072.2017.1352471] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Obesity increases the risk of heart failure (HF), which continues to be a significant proportion of all cardiovascular diseases and affects increasingly younger populations. The cross-talk between adipose and the heart involves insulin resistance, adipokine signaling and inflammation, with the capacity of adipose tissue to mediate hemodynamic signals, promoting progressive cardiomyopathy. Areas covered: From a therapeutic perspective, there is not yet a single obesity-related pathway that when addressed, can ameliorate cardiomyopathy in obese patients and this is a matter of ongoing research. There is poor evidence of the beneficial long-term effect of small nonsurgical intentional weight loss on HF outcomes, in contrast to the field of HF accompanying severe obesity where observational studies have shown that bariatric surgery is associated with improved cardiac structure/function in severely obese patients with HF and preserved ejection fraction (HFpEF) as well as with improved cardiac structure/function in those with HF and reduced ejection fraction (HFrEF). Few studies report positive outcomes in subjects with obesity and HF, both severe, who underwent bariatric surgery as a rescue treatment, including bridge to heart transplantation. Expert commentary: The fast growing prevalence of obesity will continue to require the development of appropriate interventions directed at controlling or slowing pathways of cardiac damage in these patients, but at present, bariatric surgery should be considered an option to try to decrease morbidity associated with HF in severely obese adults.
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Affiliation(s)
- Marcela Rodriguez Flores
- a Endocrinology Department , Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , Mexico
| | - Carlos Aguilar Salinas
- a Endocrinology Department , Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , Mexico
| | - Marie-Eve Piché
- b Cardiology Department , Institut Universitaire de Cardiologie et de Pneumologie de Québec , Québec , Canada.,c Faculty of Medicine , Laval University , Québec , Canada
| | - Audrey Auclair
- b Cardiology Department , Institut Universitaire de Cardiologie et de Pneumologie de Québec , Québec , Canada
| | - Paul Poirier
- b Cardiology Department , Institut Universitaire de Cardiologie et de Pneumologie de Québec , Québec , Canada.,d Faculty of Pharmacy , Laval University , Québec , Canada
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