P373Arterial stiffness changes in patients with obesity and atrial fibrillation

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Tarzimanova ◽  
V I Podzolkov ◽  
A E Bragina ◽  
M V Pisarev ◽  
R G Gataulin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Arterial Stiffness ◽  
Sinus Rhythm ◽  
Body Mass ◽  
Paroxysmal Atrial Fibrillation ◽  
Obese Patients ◽  
Waist To Hip Ratio ◽  
Group I ◽  
The Mean

Abstract Objective To study the changes in arterial stiffness in patients with obesity and paroxysmal atrial fibrillation (AF). Materials and methods The study included 82 obese patients. Forty-two of them (group I) had paroxysmal AF, their mean age was 60.9 ± 6.2 years. The control group (group II) included 40 obese patients in sinus rhythm with the mean age of 57.2 ± 6.5 years.  We studied arterial stiffness using cardio-ankle vascular index (CAVI) measured by the VaSera device (VS-1000) in all the patients. Patients from group I were evaluated after 3 days of sinus rhythm restoration and maintenance. We also measured the anthropometric indicators which included body mass index, waist circumference, abdominal sagittal diameter, waist-to-hip and waist-to-height ratios. Results There were no significant differences in body mass index between 2 groups. The waist-to-hip ratio was significantly higher in patients with obesity and paroxysmal atrial fibrillation than in obese patients in sinus rhythm and was 1.37 ± 0.09 and 0.84 ± 0.06, respectively (p = 0.002). The mean value of CAVI was 9.61 ± 1.51 and 6.42 ± 0.18 in group I and group II respectively; this difference was significant (p = 0.001). There was a strong positive correlation between CAVI and waist-to-hip ratio in the group I patients (p = 0.02). The results show that vascular stiffness is significantly higher in obesity patients with paroxysmal form AF. Conclusion Positive correlations between increased arterial stiffness and anthropometric indicators confirm the role of visceral obesity in the development of AF.

Body Mass Index can influence Connexin 43 distribution in patients with atrial fibrillation or sinus rhythm

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
S. Dhein ◽  
S. Rothe ◽  
A. Busch ◽  
H. Bittner ◽  
M. Kostelka ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Sinus Rhythm ◽  
Body Mass ◽  
Connexin 43

scholarly journals The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus

2017 ◽  
Vol 5 (3) ◽  
pp. 316-318 ◽  
Author(s):  
Serdar Olt ◽  
Sabri ÖzdaÅŸ ◽  
Mehmet Åžirik
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Body Mass Index ◽  
Type 2 Diabetes Mellitus ◽  
Body Mass ◽  
P Value ◽  
Obese Patients ◽  
The Mean

AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus.MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients' files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program.RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72].CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients.

scholarly journals Does endothelial dysfunction correlate better with waist-to-hip ratio than with body mass index or waist circumference among obese patients?

Clinics ◽  
2006 ◽  
Vol 61 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Nivaldo Ribeiro Villela ◽  
Luiz Guilherme Kraemer Aguiar ◽  
Luciana Bahia ◽  
Daniel Bottino ◽  
Eliete Bouskela
Keyword(s):  
Body Mass Index ◽  
Waist Circumference ◽  
Endothelial Dysfunction ◽  
Body Mass ◽  
Obese Patients ◽  
Waist To Hip Ratio

Accuracy of Pharmacokinetic Models for Predicting Plasma Fentanyl Concentrations in Lean and Obese Surgical Patients

2004 ◽  
Vol 101 (3) ◽  
pp. 603-613 ◽  
Author(s):  
Kinichi Shibutani ◽  
Mario A. Inchiosa ◽  
Keisuke Sawada ◽  
Mosses Bairamian
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Body Mass ◽  
Predictive Accuracy ◽  
Elective Surgery ◽  
Negative Relationship ◽  
Obese Patients ◽  
Pharmacokinetic Models ◽  
The Mean ◽  
Total Body

Background The currently available pharmacokinetic models for fentanyl were derived from normal weight patients and were not scaled to body weight. Their application to obese patients may cause overprediction of the plasma concentration of fentanyl. This study examined the influence of body weight on the predictive accuracy of two models (Anesthesiology 1990; 73:1091-102 and J Pharmacol Exp Ther 1987; 240:159-66). Further, we attempted to derive suggested dosing mass weights for fentanyl that improved predicted accuracy. Method Seventy patients undergoing major elective surgery with total body weight (TBW) &lt;85 kg and body mass index &lt;30 (Group L) and 39 patients with TBW &gt;/=85 kg and body mass index &gt;30 (Group O) were studied. In Group L and Group O, the mean TBW was 69 kg, and 125 kg, respectively and the mean body mass index in Group L and Group O was 24 and 44, respectively. Fentanyl infusion was used during surgery and postoperatively for analgesia. Plasma fentanyl concentrations were measured and predicted concentrations were obtained by computer simulation; 465 pairs of measured and predicted values were obtained. Results The influence of TBW on the performance errors of the original two models was examined with nonlinear regression analysis. Shafer error versus TBW showed a highly significant negative relationship (R squared = 0.689, P &lt; 0.001); i.e., the Shafer model systematically overestimated fentanyl concentration as weight increased. The Scott and Stanski model showed greater variation (R squared = 0.303). We used the exponential equation for Shafer performance error versus TBW to derive suggested dosing weights ("pharmacokinetic mass") for obese patients. The pharmacokinetic mass versus TBW curve was essentially linear below 100 kg (with slope of 0.65) and approached a plateau above 140 kg. For patients weighing 140 to 200 kg, dosing weights of 100-108 kg are projected. Total body clearance (ml/min) showed a strong linear correlation with pharmacokinetic mass (r = 0.793; P &lt; 0.001), whereas the relationship with TBW was nonlinear. Conclusion Actual body weight overestimates fentanyl dose requirements in obese patients. Dosing weight (pharmacokinetic mass) derived from the nonlinear relationship between prediction error and TBW proved to have a linear relationship with clearance.

Abstract 15861: The Role of Body Mass Index in Cryoballoon Ablation Outcomes for Paroxysmal Atrial Fibrillation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Abhishek Bose ◽  
Parag A Chevli ◽  
Zeba Hashmath ◽  
Ajay K Mishra ◽  
Gregory Berberian ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Paroxysmal Atrial Fibrillation ◽  
Surrogate Marker ◽  
The Body ◽  
Cryoballoon Ablation ◽  
Class 1 ◽  
Study Population ◽  
One Year

Introduction: Cryoballoon ablation (CBA) is recommended for patients with paroxysmal atrial fibrillation (AF) refractory to anti-arrhythmic drugs. However, only 70% of patients benefit from an initial CBA. Obesity is a known risk factor for development of AF but its role in predicting outcomes following CBA for paroxysmal AF remains unclear. Methods: We followed 103 patients (Age 60.6 ± 9.1, 29% women) with paroxysmal AF undergoing CBA for one year post procedure. Recurrence was assessed by documented atrial arrhythmias (AA) on EKG or any form of long-term cardiac rhythm monitoring. Using the body mass index (BMI) as a surrogate marker for obesity, we divided patients into five groups: normal <24.9 kg/m 2 , overweight 25-29.9 kg/m 2 , class 1 obesity 30-34.9 kg/m 2 , class 2 obesity 35-39.9 kg/m 2 and class 3 obesity ≥40 kg/m 2 . A multivariable cox proportional hazard model was used to assess if BMI predicted risk of AA recurrence. Results: Among our study population, 7 (6.7%) had normal BMI and 34 were overweight (33%) while 17 (16.5%), 14 (13.5%) and 8 patients (7.7%) were categorized as class 1, 2 and 3 obesity respectively. After a one year follow up, 19 (18.4%) participants developed recurrence of AA. Baseline demographics were similar between the two groups except for a higher incidence of hypertension in the class 3 obesity group. On a multivariable model adjusted for baseline demographics and risk factors for AF, neither obesity nor overweight predicted recurrence of AA following CBA (Table, p=0.18). Similarly, on Kaplan-Meier analysis, BMI did not effect time to first recurrence of AA (Figure, p=0.07). Conclusion: Obesity is strongly associated with the risk of development of AF. However, in our study population increasing BMI had no influence on the recurrence of AA following CBA for paroxysmal AF.

scholarly journals One-stage operation for superficialization of native radio-cephalic fistula in obese patients

2018 ◽  
Vol 20 (1_suppl) ◽  
pp. 45-49 ◽  
Author(s):  
Takao Okawa ◽  
Masaaki Murakami ◽  
Ryo Yamada ◽  
Satoshi Tanaka ◽  
Kiyoshi Mori ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Patency Rate ◽  
Cephalic Vein ◽  
Secondary Patency ◽  
Obese Patients ◽  
One Stage ◽  
Small Series ◽  
Secondary Patency Rate ◽  
The Mean

Purpose: The population of obese patients is increasing in general and also at hemodialysis initiation. For successful cannulation of arteriovenous fistula, the National Kidney Foundation-Dialysis Outcome Quality Initiative guidelines suggest that the required maturation parameters are at a depth of <6 mm. There are several reports describing two-stage superficialization of arteriovenous fistulas in obese cases. Therefore, we investigated the utility and complications of one-stage superficialization of radio-cephalic fistula. Methods: From January 2011 to March 2017, we simultaneously performed forearm radio-cephalic fistula creation and superficialization of the cephalic vein for 10 patients having obesity (body mass index > 30 kg/m2) and deep cephalic vein (>6 mm). Initially, an arteriovenous anastomosis was created at an appropriate site. Subsequently, an 8–10 cm longitudinal skin incision was made along the lateral aspect of the forearm cephalic vein. The cephalic vein was identified and exposed. The cephalic vein was repositioned superficially. Results: The mean age of the patients was 53 years (range: 40–72 years) and the mean body mass index was 40.2 kg/m2 (33.1–59.7 kg/m2). The cause of renal failure in eight patients was diabetic nephropathy, and in two patients, it was unknown. After the procedure, vein depth became 3.4 mm (1.9–4.6 mm) from 8.2 mm (6.0–13.4 mm). All patients who initiated dialysis underwent successful two-needle cannulation. Primary patency rate was 71.4% at 12 months (two patients underwent percutaneous transluminal angioplasty) and secondary patency rate was 100%. There was one procedure-related complication and delayed wound healing, which was improved by observation without antibiotics. Conclusion: This small series of patients indicates that one-stage superficialization of radio-cephalic fistula is a safe and effective option to start hemodialysis in obese subjects.

scholarly journals AB0615 ASSESSMENT OF THE IMPACT OF OBESITY ON BONE LOSS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1342.3-1342
Author(s):  
M. Yasmine ◽  
S. Mariem ◽  
S. Miladi ◽  
A. Fazaa ◽  
E. Frigui ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Vertebral Fracture ◽  
Body Mass ◽  
World Health ◽  
Obese Patients ◽  
Mineral Density ◽  
Cross Sectional ◽  
Tunisian Patients ◽  
The Mean ◽  
The Impact

Background:Most of the available evidence supports a lower risk of vertebral fracture in obese adults. This belief was partially suggested by the positive correlation between bone mineral density (BMD) and body mass index (BMI).Objectives:We aimed to assess the association of BMI with BMD and to explore their relation with age and gender.Methods:This is a cross-sectional study including Tunisian patients referred for an assessment of BMD through dual-energy X-ray absorptiometry (DXA). BMD was measured using standard methods over the lumbar spine L1-L4, the total proximal femur. The results were expressed as T-scores according to the World Health Organization definition. Patients were sub-grouped according to age (≤50 and >50 years). Association between BMD and age as well as BMI was also assessed (G1: obese patients and G2: non-obese patients). The level of significance was fixed for p<0.05Results:The study included 100 patients with a female predominance (sex ratio =10.1). The mean age for women was 61.9 ±13 [18-83] years and the mean age for men was 59.7± 7.5 [47-72] years. The mean body mass index was 29.1± 5 kg/m2 [15-45] for women and 27.6 ±3.6 Kg/m2 [22.8-32.9] for men. Forty percent of all patients were obese with a mean BMI of 32.9 kg/m2 ± 4.3. Osteopenia was diagnosed in half of the men (55.5%) and most of the women (70%). Twenty-nine percent of patients suffered from osteoporosis. BMD of the spine was similar between men and women (p=0.53). Men had higher BMD of the hip than women (p=0,038). The mainstream of the subjects >50 years had more vertebral fractures, suffered more from osteoporosis and had a higher BMI than those < 50 years (95% % vs 5%; p=0.04), (92.3% vs 77 %; p=0.03) and (82.5% vs 17.5%; p=0.05) respectively. There was no correlation between BMD of the spine and higher BMI (0.94 in G1 vs 0.98 in G2, p=0.3). Similarly, there was no correlation between BMD of the hip and higher BMI (0.9 in G1 vs 0.84 in G2, p=0.2). Moreover, Obese patients had less a vertebral fracture but with no statistically significant correlation (21% in G1 vs 25% in G2; p=0.2).Conclusion:Our study showed that obesity was frequent among Tunisian patients but was not associated with a higher BMD. Older age was directly associated with a lower BMD and higher risk for vertebral fracture.Disclosure of Interests:None declared.

Comprehensive Intraprocedural Unfractionated Heparin Protocol During Catheter Ablation of Atrial Fibrillation in the Presence of Direct Oral Anticoagulants and Wide Spectrum of Body Mass Index

2021 ◽  
pp. 107424842199849
Author(s):  
Michael Safani ◽  
Serge Tobias ◽  
Adrian H. Shandling ◽  
Kathryn Redmond ◽  
Mark Young Lee
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Catheter Ablation ◽  
Unfractionated Heparin ◽  
Body Mass ◽  
Wide Spectrum ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Optimal Dosing ◽  
The Mean

Introduction: Data on optimal dosing of unfractionated heparin (UFH) in the presence of a direct oral anticoagulant (DOAC) to achieve and maintain an activated clotting time (ACT) of ≥300 seconds during catheter ablation of atrial fibrillation (CA-AF) are limited and prevalence of obesity adds to the unpredictable response to UFH. Methods and Results: One hundred seventeen consecutive patients undergoing CA-AF were prospectively administered weight-adjusted, weight-based UFH using a pre-specified detailed protocol and retrospectively analyzed. Due to lack of distribution of UFH into muscle or adipose tissue and lower degree of vascularity in the latter compartment, each patient’s ideal and actual weights were used to determine the adjusted-weight for use in all UFH doses. A UFH bolus of 200 units/kg was administered intravenously followed by an infusion of 35 units/kg/hour. The mean age was 65 years, and 85 patients (72.6%) were male. The average body mass index (BMI) was 30 (range 18-50) kg/m2. After the initial UFH bolus dose, 99 patients (84.6%) achieved ACT ≥300 sec with a mean (± SD) of 380 ± 79 sec. The mean time to reach an ACT ≥300 in all patients was 14.6 ± 12.4 minutes. Among all measured ACT values, 423 (90.8%) were ≥300 seconds. These results were consistent within all BMI categories. There were no intraprocedural thrombotic or hemorrhagic complications. Two patients (1.7%) sustained groin vascular access site hematoma without subsequent intervention and 7 patients (6%) experienced minor oozing post-procedurally. Conclusions: Our comprehensive weight-adjusted, weight-based UFH protocol, during CA-AF in presence of a DOAC, rapidly achieved and maintained an effective ACT irrespective of BMI.

scholarly journals The Relationship of Vitamin D Status with Body Mass Index Among Obese Patients Registered to the Obesity Center

2021 ◽  
Author(s):  
Mahcube Çubukçu ◽  
Eda Türe ◽  
Bahadır Yazıcıoğlu ◽  
Erdinç Yavuz
Keyword(s):  
Body Mass Index ◽  
Vitamin D ◽  
Body Mass ◽  
Vitamin D Insufficiency ◽  
Obese Patients ◽  
Vitamin D Levels ◽  
Class 1 ◽  
Chi Squared ◽  
The Mean ◽  
Relationship Of

Objective: In our study, we aimed to determine vitamin D levels among obese patients registered to Obesity Center and to investigate its relationship with body mass index (BMI). Methods: The study was conducted in the Obesity Center of Health Sciences University Samsun Training and Research Hospital. Records of 102 patients with BMI> 30 kg/m², 18 years of age and over, admitted to the obesity center between 01.12.2018 and 01.12.2019 were retrospectively analyzed. Serum 25-OH D level<20 ng/ml was accepted as severe insufficiency, 20-30 ng/ml insufficiency, >30 ng/ml proficiency. Mann-Whitney U, Pearson chi-squared and Spearman tests were used in the evaluation of the data. The data were evaluated by the SPSS 22.00 program. p<0.05 was considered significant. Results: A total of 102 patients participated. The mean age was 48.82±12.09 years. 62.75% of them were female. 24.51% of participants were class 1 obese, 32.35% of participants were class 2 obese, 43.14% of participants were class 3 obese. The prevalance of severe vitamin D insufficiency was 45.10% and insufficiency in 38.24% of the patients. The mean vitamin D levels of the patients registered to the Obesity Center was 13.26±7.74 ng/ml. The mean BMI was 35.26±4.28 kg/m². Serum 25-(OH)D levels were inversely related to BMI. There was a significant relationship between age and BMI (p=0.036). Conclusion: Vitamin D insufficiency is highly prevalent in obese patients registered to Obesity Center. Serum 25-(OH)D levels were inversely associated with BMI. Obese patients should be evaluated and followed for vitamin D insufficiency.

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