Bariatrik Cerrahi ile Kilo Kaybının Kardiyak Fonksiyonlara Etkisinin Ekokardiyografi İle Değerlendirilmesi

Year 2016, Volume: 7 Issue: 27, 0 - 0, 18.06.2016

AHMET Akçay , İmran Ceren Gürkan Acar , Huseyin Nacar Mehmet Çelebi , Kemal Göçer İdris Ardıç , Abdullah Sökmen

https://doi.org/10.17944/mkutfd.66764

Abstract

Amaç: Bariatrik cerrahi tedavi hızlı bir şekilde kilo kaybında çok etkili olmaktadır. Bu çalışmamızda obezite cerrahisi öncesi ve sonrasında biyokimyasal ve ekokardiyografik olarak kardiyak fonksiyonları inceledik.

Gereç ve Yöntem: Çalışmamıza prospektif olarak Genel cerrahi polikliniğinde bariatrik cerrahiye (laparoskopik sleeve gastrektomi) uygun olarak değerlendirilen, 23-55 yaş arası, morbit obez ( VKİ 47.8 ± 7.3 kg/m2 ) olan 30 (22 kadın ve 8 erkek ) hasta alınmıştır. Hastaların fizik muayene ve biyokimyasal testleri yapıldı. Bariatrik cerrahi öncesi ve 6 ay sonrası konvensiyonal ve doku doppler ekokardiyografi parametreleri, sol ve sağ ventrikül fonksiyonları, miyokard performans indeksleri (MPI), sol ve sağ atriyal volüm endeksleri ölçüldü.

Bulgular: VKİ cerrahi öncesi 47.8 ±7.3 kg/m2 iken 6 ay sonunda 34.1±7.1 kg/m2 ölçüldü (p<0.001).  Kalp hızı (p= 0.020) ve sistolik (p = 0.003) ve diyastolik kan basıncı (p = 0.009) ve plasma açlık glukoz (p<0.001) değerleri iki grup arasında anlamlı düşük bulundu. Sol ventrikül diyastol sonu çapı, sol ventrikül kitlesi, Triküspit E/A oranı ve sol atrium volüm indeksi anlamlı olarak farklı idi (sırasıyla p= 0.026, p= 0.010, p<0.001, p= 0.006 ). Sol ventrikül septal MPI (0.44±0.06 ;    0.40±0.06, p=0.05) ve sağ ventrikül MPI anlamlı şekilde düştüğü gözlendi (0.43±0.08       ; 0.35±0.05, p<0.001).

 

Sonuç: Kilo kaybının morbid obez hastalarda kardiyak fonksiyonları iyileştirdiğini düşündürmektedir. Bulgularımız hastaların sistolik ve diyastolik fonsiyonlarında olumsuz değişme olmadığını, ayrıca  myokard performans indeksinin iyileştiği sonucunu ortaya koymuştur.

 

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