Bariatric Times - December 2008 - (Page 30)

30 Journal Watch Bariatric Times • December 2008 J o u r n a l Wa t c h Recent articles in bariatric multidisciplinary health McCloskey CA, Ramani GV, Mathier MA, et al. Surg Obes Relat Dis. 2007;3(5):503–507. Synopsis: Authors retrospectively evaluated short-term morbidity/mortality, length of stay, excess weight loss, pre- and postoperative left ventricular ejection fraction, and New York Heart Association (NYHA) functional class in 14 patients (4 female) with a left ventricular ejection fraction who underwent bariatric surgery from 1998 to 2005. They found, among other things, that six months after surgery left ventricular ejection fraction had significantly improved and NYHA classifications had decreased, and concluded that bariatric surgery for patients with cardiomyopathy is feasible and effective. PMID: 17903770 Impact of bariatric surgery— induced weight loss on heart rate variability. Nault I, Nadreau E, Paquet C, et al. Metabolism 2007;56(10):1425–1430. Synopsis: To assess the effect of surgically induced weight loss on heart rate variability and ventricular size and function, researchers used 24-hour Holter monitoring and echocardiogram to measure changes in minimal, maximal, and mean heart rate along with heart rate variability during daytime and nighttime, before and after surgery, in 10 morbidly obese patients (6 female) who underwent bariatric surgery and seven morbidly obese patients who did not have surgery. Based on the results, authors conclude that weight loss after bariatric surgery enhances heart rate variability and decreases mean and minimal heart rate during Holter monitoring through a better cardiac parasympathetic modulation. PMID: 17884456 Body composition and metabolic changes following bariatric surgery: effects on fat mass, lean mass, and basal metabolic rate: six months to one-year follow-up. Carey DG, Pliego GJ, Raymond RL. Obes Surg. 2006;16(12):1602–1608. Synopsis: Authors tracked body composition and metabolic changes— weight, lean body mass, fat mass, percent body fat, and basal metabolic rate—for one year following bariatric surgery in 17 patients (12 female). They found that weight, fat mass, and percent body fat significantly decreased for all time periods, lean body mass significantly decreased in the first six months, and basal metabolic rate significantly decreased from presurgery to one month post-surgery. PMID: 17217636 Evolutive echocardiographic study of the structural and functional heart alterations in obese individuals after bariatric surgery. Cunha Lde C, da Cunha CL, de Souza AM, et al. Arq Bras Cardiol. 2006;87(5):615–622. English, Portuguese. Synopsis: Researchers used Doppler echocardiography to assess the reversibility of structural and hemodynamic changes at baseline and six months and three years after bariatric surgery in 23 obese patients (19 female). At six months, they found reductions in mean weight and blood pressure, thinning of the ventricular septum and left ventricular (LV) posterior wall, increase in LV diastolic dimension, improvement in the Myocardial Performance Index, and increase of the ejection time. At three years they found reduction in mean weight, stable blood pressure, a normal predominant LV pattern, improved diastolic function, and an elevation of the ejection fraction. Authors conclude that surgically induced weight loss promotes both structural and functional myocardial changes that improve cardiac performance. PMID: 17221038 Cardiovascular risk after bariatric surgery for obesity. Batsis JA, Sarr MG, Collazo-Clavell ML, et al. Am J Cardiol. 2008;102(7):930–937. Synopsis: To determine whether bariatric surgery reduces long-term cardiovascular events, authors applied cardiovascular risk models to a previously published validation cohort of 197 patients who underwent Rouxen-Y gastric bypass and 163 control patients. They found estimated relative risk reductions for bariatric surgery patients compared to the controls ranged from 18 to 79 percent using the Framingham risk score and 8 to 62 percent using the PROCAM risk score, and conclude that bariatric surgery predicts long-term decreases in cardiovascular risk in obese patients. PMID: 18805125 by Laura Alexander METABOLISM, CARDIAC FUNCTION, AND BARIATRIC SURGERY Dramatic reversal of derangements in muscle metabolism and left ventricular function after bariatric surgery. Leichman JG, Wilson EB, Scarborough T, et al. Am J Med. 2008;121(11):966–973. Synopsis: Researchers conducted a prospective, longitudinal study of 43 clinically severe obese patients who underwent metabolic profiling, skeletal muscle biopsies, and resting echocardiograms at baseline and three and nine months after bariatric surgery. They found that at nine months after surgery, BMI decreased, insulin sensitivity was restored, plasma leptin decreased, muscle metabolic derangements decreased, and left ventricular diastolic function normalized. PMID: 18954843 Weight loss after bariatric surgery improves aortic elastic properties and left ventricular function in individuals with morbid obesity: a three-year follow-up study. Ikonomidis I, Mazarakis A, Papadopoulos C, et al. J Hypertens. 2007;25(2):439–447. Synopsis: In this study, researchers used echocardiography to evaluate changes in aortic function and left ventricular function at baseline and three and 36 months later in three groups of individuals: obese individuals who underwent bariatric surgery (n=60), obese individuals who neither underwent surgery nor lost weight (n=20), and lean individuals of similar age, sex, and risk factors (at baseline only, n=40). Based on the results, authors conclude that weight loss after bariatric surgery normalizes aortic function, reduces left ventricular hypertrophy, and improves left ventricular diastolic function over the three years post-surgery. PMID: 17211252 Bariatric surgery improves cardiac function in morbidly obese patients with severe cardiomyopathy. THIAMINE DEFICIENCY AND WERNICKE ENCEPHALOPATHY AFTER WEIGHT LOSS SURGERY Wernicke encephalopathy after bariatric surgery: a systematic review. Aasheim ET. Ann Surg. 2008;248(5):714–720. Synopsis: In this article, authors conducted a literature search and, using 84 included cases, review the clinical aspects of Wernicke encephalopathy after bariatric surgery. Authors conclude that recent increases in the use of bariatric surgery in the United States are associated with increases in reported Wernicke encephalopathy cases, and that the number of Wernicke encephalopathy cases after bariatric surgery is substantially higher than previously reported. PMID: 18948797 Wernicke encephalopathy after obesity surgery: a systematic review. Singh S, Kumar A. Neurology. 2007;68(11):807–811. Review. Synopsis: Authors review 32 cases of Wernicke encephalopathy after bariatric surgery from the literature, and characterize the disorder’s clinical features, risk factors, radiographic findings, and prognosis. PMID: 17353468 Acute Wernicke’s encephalopathy following bariatric surgery: clinical course and MRI correlation. Loh Y, Watson WD, Verma A, et al. Obes Surg. 2004;14(1):129–132.

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Bariatric Times - December 2008 Table of Contents Patient Management Perspective Diabetes Perspective Interview: ASMBS’s Georgeann Mallory Editorial Message Editorial Board Body Contouring Perspective Meeting Perspective Journal Watch Advertiser Index News & Trends

Bariatric Times - December 2008

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