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Ultrasound and Morbidly Obese Patient

  • Pavoni VittorioEmail author
  • Poli Claudio
  • Cipani Simone
Chapter

Abstract

Obesity is a condition of excessive body fat. The prevalence of significant obesity continues to rise in both developed and developing countries. Adipose tissue distribution may be better predictor of health risk. Morbidity and mortality rise sharply when the BMI is >30 kg/m−2.

Morbidly obese individuals are at greater risk of mortality from diabetes, cardiorespiratory and cerebrovascular disorders and certain forms of cancer. Echocardiography plays a major role in quantifying left heart chamber dimensions, which are thought to increase proportionally with increasing body size.

Keywords

Morbidly obese patient Cardiovascular disease Body mass index Echocardiography 

Further Reading

  1. Adabag S, Huxley RR, Lopez FL, et al. Obesity related risk of sudden cardiac death in the atherosclerosis risk in communities study. Heart. 2015;101:215–21.CrossRefGoogle Scholar
  2. Alauddin A, Neterissian S, Lisbona R, NacLean LD, Forse RA. Assessment of cardiac function in patients who were morbidly obese. Surgery. 1990;108:809–20.Google Scholar
  3. Alexander JK. Obesity and cardiac performance. Am J Cardiol. 1964;14:860–5.CrossRefGoogle Scholar
  4. Alexander JK, Woodard CB, Quinones MA. Heart failure from obesity. In: Mancini M, Lewis B, Contaldo F, editors. Medical complications of obesity. London: Academic Press; 1978. p. 178–87.Google Scholar
  5. Alpert NA, Hashimi NW. Obesity and the heart. Am J Med Sci. 1993;306:117–23.CrossRefGoogle Scholar
  6. Alpert MA, Terry BE, Kelly DL. Effect of weight loss on cardiac chamber size, wall thickness and left ventricular function in morbid obesity. Am J Cardiol. 1985;55:783–6.CrossRefGoogle Scholar
  7. Alpert NA, Singh A, Terry BE. Effect of exercise on left ventricular function and reserve in morbid obesity. Am J Cardiol. 1989;63:1478–82.CrossRefGoogle Scholar
  8. Alpert NA, Terry BE, Lambert CR, et al. Factors influencing left ventricular systolic function in nonhypertensive morbidly obese patients, and effect of weight loss induced by gastroplasty. Am J Cardiol. 1993;71:733–7.CrossRefGoogle Scholar
  9. Alpert NA, Lambert CR, Panayiotou H, et al. Relation of duration of morbid obesity to left ventricular mass, systolic function, and diastolic filling, and effect of weight loss. Am J Cardiol. 1995;76:1194–7.CrossRefGoogle Scholar
  10. Ashrafian H, le Roux CW, Darzi A, Athanasiou T. Effects of bariatric surgery on cardiovascular function. Circulation. 2008;118:2091–102.CrossRefGoogle Scholar
  11. Ashwell M, Chinn S, Stalley S, Garrow JS. Female fat distribution: a simple classification based on two circumference measurement. Int J Obes. 1982;6:143–52.PubMedGoogle Scholar
  12. Azevedo A, Ramos E, von Hafe P, Barros H. Upper-body adiposity and risk of myocardial infarction. J Cardiovas Risk. 1999;6:32l–5.Google Scholar
  13. Basoor A, Cotant JF, Randhawa G, et al. High prevalence of obesity in young patients with ST elevation myocardial infarction. Am Heart Hosp J. 2011;9:37–40.CrossRefGoogle Scholar
  14. Bjorntop P. Visceral obesity: a “civilization syndrome”. Obes Res. 1993;1:206–22.CrossRefGoogle Scholar
  15. Bjorntorp P. Obesity. Lancet. 1997;350:423–6.CrossRefGoogle Scholar
  16. Bray GA. Pathophysiology of obesity. Am J Clin Nutr. 1992;55:488S–94S.CrossRefGoogle Scholar
  17. Brodksy JB. Anesthetic management of the morbidly obese patient. Int Anesthesiol Clin. 1986;24:93–103.Google Scholar
  18. Dewey FE, Rosenthal D, Murphy DI Jr, et al. Does size matter? Clinical applications of scaling size and function for body size. Circulation. 2008;117:2279–87.CrossRefGoogle Scholar
  19. Drenick EJ, Fisler JS. Sudden cardiac arrest in morbidly obese surgical patients unexplained after autopsy. Am J Surg. 1988;155:720–6.CrossRefGoogle Scholar
  20. Eckel RH. Obesity and heart disease: a statement for healthcare professionals from the Nutrition Committee, American Heart Association. Circulation. 1997;96:3248–50.CrossRefGoogle Scholar
  21. Franzosi MG. Should we continue to use BMI as a cardiovascular risk factor? Lancet. 2006;368:624–5.CrossRefGoogle Scholar
  22. Garfinkel L. Overweight and cancer. Ann Intern Med. 1985;103:1034–6.CrossRefGoogle Scholar
  23. Garrison RJ, Castelli WP. Weight and thirty-year mortality of men in the Framingham study. Ann Intern Med. 1985;103:1006–9.CrossRefGoogle Scholar
  24. Grundy SM, Hansen B, Smith SC, et al. American Heart Association, National Heart, Lung, and Blood Institute, American Diabetes Association. Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management. Arterioscler Thromb Vasc Biol. 2004;24(2):e19–24.PubMedGoogle Scholar
  25. Gutgesell HP, Rembold CM. Growth of the human heart relative to body surface area. Am J Cardiol. 1990;65:662–8.CrossRefGoogle Scholar
  26. Hsieh SD, Yoshinaga H. Abdominal fat distribution and coronary heart disease risk factors in me-waist/height ratio as a simple and useful predictor. Int J Obes Relat Metab Disord. 1995;19:585–9.PubMedGoogle Scholar
  27. James WP. Assessing obesity: are ethnic differences in body mass index and waist classification criteria justified? Obes Rev. 2005;6:179–81.CrossRefGoogle Scholar
  28. Jern S, Bergbrant P, Hansson L. Relation of central hemodynamics to obesity and body fat distribution. Hypertension. 1992;19(6 Pt 1):520–7.CrossRefGoogle Scholar
  29. Kaltman AJ, Goldring RM. Role of circulatory congestion in cardiorespiratory failure of obesity. Am J Med. 1976;60:645–53.CrossRefGoogle Scholar
  30. Lang RM, Biering M, Devereux RB, Flachskampf FA, et al. Chamber quantification writing group, American Society of Echocardiography’s Guidelines and Standards Committee, European Association of Echocardiography. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.CrossRefGoogle Scholar
  31. Lapidus L, Bengtsson C, HallstrOm T, Bjorntorp P. Obesity, adipose tissue distribution and health in women — results from a population study in Goteborg, Sweden. Appetite. 1989;12:25–35.CrossRefGoogle Scholar
  32. Larsson B, Svardsudd K, Welin L, Wilhelmsen L, BjSrntorp P, Tibblin G. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year of follow up of participants in the study of men born in 1913. Br Med J. 1984;288(6428):1401–4.CrossRefGoogle Scholar
  33. Lauer MS, Anderson KM, Levy D. Separate and joint influences of obesity and mild hypertension on left ventricular mass and geometry: the Framingham heart study. J Am Coll Cardiol. 1992;19:130–4.CrossRefGoogle Scholar
  34. Lauer MS, Anderson KM, Larson MG, et al. A new method for indexing left ventricular mass for differences in body size. Am J Cardiol. 1994;74:487–91.CrossRefGoogle Scholar
  35. Lavie CJ, Milani RV, Ventura HO. Obesity and cardiovascular disease: risk factor, paradox, and impact of weight loss. J Am Coll Cardiol. 2009;53(21):1925–32.CrossRefGoogle Scholar
  36. Lesser GT, Deutsch S. Measurement of adipose tissue blood flow and perfusion in man by uptake of 85Kr. J Appl Physiol. 1967;23:621–30.CrossRefGoogle Scholar
  37. Linde B, Chisolm G. The interstitial space of adipose tissue as determined by single injection and equilibration techniques. Acta Physiol Scand. 1975;95:383–90.CrossRefGoogle Scholar
  38. Madala MC, Franklin BA, Chen AY, et al. Obesity and age of first non-ST segment myocardial infarction. J Am Coll Cardiol. 2008;52:979–85.CrossRefGoogle Scholar
  39. Messerli FH. Cardiomyopathy of obesity: a not-so-Victorian disease. N Engl J Med. 1986;314:378–80.CrossRefGoogle Scholar
  40. Moller JE, Hills GS, Oh JK, et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003;107:2207–12.CrossRefGoogle Scholar
  41. National Institutes of Health Consensus Development Conference Statement. Health implications of obesity. Ann Intern Med. 1985;103:147–50.CrossRefGoogle Scholar
  42. Noheria A, Teodorescu C, Uy-Evanado A, et al. Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults: a community-based study. Int J Cardiol. 2013;168:3495–9.CrossRefGoogle Scholar
  43. Oberg B, Rosell S. Sympathetic control of consecutive vascular sections in canine subcutaneous adipose tissue. Acta Physiol Scand. 1967;71:47–57.CrossRefGoogle Scholar
  44. Pathak RK, Mahajan R, Lau DH, et al. The implications of obesity for cardiac arrhythmia mechanisms and management. Can J Cardiol. 2015;31:203–10.CrossRefGoogle Scholar
  45. Paul DR, Hoyt JL, Boutros AR. Cardiovascular and respiratory changes in response to change of posture in the very obese. Anesthesiology. 1976;45:73–8.CrossRefGoogle Scholar
  46. Perry AC, Applegate EB, Allison MD, Jackson ML, Miller PC. Clinical predictability of the waist-to-hip ratio in assessment of cardiovascular disease risk factor in overweight, premenopausal women. Am J Clin Nutr. 1998;68:1022–7.CrossRefGoogle Scholar
  47. Poirier P, Cornier MA, Mazzone T, et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation. 2011;123:1683–701.CrossRefGoogle Scholar
  48. Rodrigues LS, Baldo MP, Cunha R, et al. Anthropometric measures of increased central and overall adiposity in association with echocardiographic left ventricular hypertrophy. Hypertens Res. 2010;33:83–7.CrossRefGoogle Scholar
  49. Rosell S, Belfrage E. Blood circulation in adipose tissue. Physiol Rev. 1979;59:1078–104.CrossRefGoogle Scholar
  50. Russo C, Jin Z, Homma S, Rundek T, Elkind MSV, Sacco RL, Di Tullio MR. Effect of obesity and overweight on left ventricular diastolic function: a community based study in elderly cohort. J Am Coll Cardiol. 2011;57(12):1368–74.CrossRefGoogle Scholar
  51. Sluysmans T, Colan SD. Theoretical and empirical derivation of cardiovascular allometric relationship in children. J Appl Physiol. 2005;99:445–57.CrossRefGoogle Scholar
  52. Smith HL, Willius FA. Adiposity of the heart. Arch Intern Med. 1933;52:911–31.CrossRefGoogle Scholar
  53. Tanner JM. Fallacy of per weight and per surface area standards, and their relation to spurious correlation. J Appl Physiol. 1949;2:1–15.CrossRefGoogle Scholar
  54. Vasan RS. Cardiac function and obesity Framingham Heart Study. Heart. 2003;89(10):1127–9.CrossRefGoogle Scholar
  55. Yao GH, Vallurupalli N, Cui J, Hiser WL, et al. Allometric model improves scaling of left atrial size in obese population: the use of body weight containing variables is challenged. Echocardiography. 2011;28:253–60.CrossRefGoogle Scholar
  56. Zile MR, Brutsaert DL. New concepts in diastolic dysfunction and diastolic heart failure: Part I. Circulation. 2002;105:1387–93.CrossRefGoogle Scholar
  57. Zong P, Zhang L, Shaban N, et al. Left heart chamber quantification in obese patients: how does larger body size affect echocardiographic measurement? J Am Soc Echocardiogr. 2014;27(12):1267–74.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Anesthesia and Intensive CareSanta Maria Nuova HospitalFlorenceItaly

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