risco cardiovascular e cirurgia bariátrica

25
Cirurgia Bariátrica Diferentes Técnicas e Seus Resultados

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Page 1: Risco Cardiovascular e Cirurgia Bariátrica

Cirurgia Bariátrica Diferentes Técnicas e Seus Resultados

Page 2: Risco Cardiovascular e Cirurgia Bariátrica
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Adjustable Gastric Band

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Weight Loss?

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How Bariatric Surgery Prevents CV Events?

Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

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Weight LossVisceral fatSympathetic overactivityLong-term morbidity

DMT2Metabolic Syndrome

Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

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MetabolismHDL cholesterolTriglycerides and LDL - cholesterolInsuline sensitivityApoprotein ApoA4Adiponectin

Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

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Improved of Endothelial Dysfunction

Oxydized LDLVEGF-AICAM-1Endotelin-1E-selectinESR, WBC, HsCRP

Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

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Organ Damage

NAFLD and liver steatosisliver enzymes

kidney function

Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

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Cardiovascular Performance

Obstructive Sleep Apnea SyndromeLeft Ventricular HypertrophyHypertension Improvement of markers of early atherosclerosis

Nutrition, Metabolism & Cardiovascular Diseases (2015) 25, 437e443

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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

Page 15: Risco Cardiovascular e Cirurgia Bariátrica

International Journal of Cardiology 173 (2014) 20–28

Meta-analyses of mortality risk after bariatric surgery as compared

to no surgery.

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International Journal of Cardiology 173 (2014) 20–28

Meta-analysis of risk of myocardial infarction after bariatric

surgery compared to no surgery.

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International Journal of Cardiology 173 (2014) 20–28

Meta-analysis of stroke risk after bariatric surgery

as compared to no surgery

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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

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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

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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?