Bariatric surgery

1. Monday,
January 23,
2023
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Obesity and the Heart
PROFESSOR DR. HIWA OMER AHMED
GENERAL AND BARIATRIC SURGERY
University of Sulaimani-College of
Medicine Kurdistan-Iraq

2. Monday,
January 23,
2023
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Obesity
 The definition of obesity is based on body mass index (BMI), a
number calculated from a person’s height and weight.
 A normal BMI is between 18 and 25,
 BMI higher than 30 is considered obese.
 Obesity has been increasing as a problem in the United States,
and currently more than 30% of US adults are obese.
 Obesity has been linked to many different health concerns,
including heart disease, diabetes, sleep apnea, cancer, and
arthritis.

3. Pathophysiology
1. It can increase the cholesterol levels. lower good high-
density lipoproteins (HDL).
2. It can cause h blood pressure to rise. Obese individuals
require more blood to supply oxygen and nutrients to their
bodies which causes an increase in blood pressure, it requires
more pressure to move this blood around.
3. Obese individuals also have a much greater chance of
developing diabetes. Individuals with diabetes are said to be
two to four times more likely to be at risk for heart disease,
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January 23,
2023
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4. Abdominal fat
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January 23,
2023
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 Abdominal, epicardial fat is metabolically active, requires
energy, and produces a number of compounds that affect
the cardiovascular system both directly and indirectly.
 The high metabolic requirements of both lean and visceral
adipose body mass drive
1. A higher cardiac output and workload, and an increase in LV
mass.
2. Ustained by increase in both stroke volume and heart rate.
3. attributable to both volume overload and the lack of an
offsetting decrease in peripheral resistance.

5. Monday,
January 23,
2023
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Coronary artery disease
 Obesity is a risk factor for coronary artery disease
(CAD), which results from cholesterol plaque buildup
in the arteries of the heart.
 Although obesity is linked to many other risk factors
for CAD, such as diabetes, high cholesterol, high
blood pressure, and metabolic syndrome, obesity is
also a risk factor for CAD.
 The risk for CAD is higher in people with “central” or
“visceral” obesity that is concentrated in the abdomen.

6. Monday,
January 23,
2023
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Heart failure
 Obesity is a risk factor for heart failure even in people without
CAD.
 There are 2 main explanations.
1. Obese individuals tend to have greater amounts of blood, which
makes the heart pump harder and can lead to heart failure over
time. Because the heart works harder, its muscle size increases,
a condition called ventricular hypertrophy.
2. Obesity is linked to sleep apnea,> hypoxia which causes lung
problems as well as high blood pressure, both of which can
eventually lead to heart failure.

7. Monday,
January 23,
2023
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Atrial fibrillation
 Many studies have shown that obesity is a risk factor
for atrial fibrillation.
 In many cases, atrial fibrillation is seen in heart
failure. Therefore, the pathways among obesity, heart
failure, and atrial fibrillation are all closely related.

8. Monday,
January 23,
2023
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Sudden cardiac death
 Some studies have shown that obesity is linked to a
higher chance of sudden cardiac death, even in
individuals without CAD, heart failure, or other types of
heart disease.
 Inmost cases there is obesity cardiomyopathy.

9. Monday,
January 23,
2023
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Prevention and Treatment
 Heart problems related to obesity can be improved or
even resolved with weight loss.
 A healthy diet combined with aerobic exercise should
be the first approach to weight loss.
 But if these lifestyle modifications are not effective,
bariatric surgery (gastric bypass orothers botox,
ballongastric band) may be an option.