Risco Cardiovascular e Cirurgia Bariátrica
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Transcript of Risco Cardiovascular e Cirurgia Bariátrica
Cirurgia Bariátrica Diferentes Técnicas e Seus Resultados
Adjustable Gastric Band
Weight Loss?
How Bariatric Surgery Prevents CV Events?
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443
Weight LossVisceral fatSympathetic overactivityLong-term morbidity
DMT2Metabolic Syndrome
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443
MetabolismHDL cholesterolTriglycerides and LDL - cholesterolInsuline sensitivityApoprotein ApoA4Adiponectin
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443
Improved of Endothelial Dysfunction
Oxydized LDLVEGF-AICAM-1Endotelin-1E-selectinESR, WBC, HsCRP
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443
Organ Damage
NAFLD and liver steatosisliver enzymes
kidney function
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443
Cardiovascular Performance
Obstructive Sleep Apnea SyndromeLeft Ventricular HypertrophyHypertension Improvement of markers of early atherosclerosis
Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443
Bariatric surgery and its impact on cardiovascular disease and mortality: A systematic review and meta-analysis
Chun Shing Kwok, Ashish Pradhan , Muhammad A. Khan , Simon G. Anderson , Bernard D. Keavney , Phyo Kyaw Myint , Mamas A.
Mamas , Yoon K. Loke
International Journal of Cardiology 173 (2014) 20–28
International Journal of Cardiology 173 (2014) 20–28
Meta-analyses of mortality risk after bariatric surgery as compared
to no surgery.
International Journal of Cardiology 173 (2014) 20–28
Meta-analysis of risk of myocardial infarction after bariatric
surgery compared to no surgery.
International Journal of Cardiology 173 (2014) 20–28
Meta-analysis of stroke risk after bariatric surgery
as compared to no surgery
Insulin Resistance and Cardiovascular Risk Marker Evaluation in Morbid
Obesity 12 Months After Bariatric Surgery Compared to Weight-Matched
Controls
OBES SURG (2014) 24:349–358
Bariatric and Metabolic Surgery in Adolescents: a Path to Decrease Adult Cardiovascular Mortality
Curr Atheroscler Rep (2015) 17: 53
Bogalusa study : 9167 children/10 years follow-up (mean age 10 years) - 87 % of those whose BMI was above the 95th percentile in childhood were obese as adults (mean age 28 years)
Boyd Orr Cohort : 4999 children - 65years followup: clear relationship between BMI and mortality
LVH can occur early in life and BMI and total adipose tissue mass predict abnormal ventricular geometry in children and adolescents
Adolescents with dyslipidemia and overweight or obesity have had increases in adult carotid intimal medial thickness
Younger age of onset of T2DM (BMI) could be expected to lead to earlier CV complications.
Obesity is associated with chronic inflammation, and this has also been shown in children
Why should we think in Bariatric Surgery as an option for our patients?
Is Bariatric Surgery the solution?
Should it be included as a therapeutic option?