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?