Skip to main content

Advertisement

SpringerLink
Log in

Weight gain potential—a neglected entity during valve replacement

  • Original Article
  • Published:
Indian Journal of Thoracic and Cardiovascular Surgery Aims and scope Submit manuscript

Abstract

Introduction

During valve replacement, appropriate valve size will be chosen based on many factors, neglecting the potential of the patient for gaining weight. We aimed at evaluating the weight gain potential and its effect on hemodynamics in post mitral valve replacement (MVR) patients.

Material and methods

In 118 post-MVR patients, demographic and echocardiographic data at the time of discharge and follow-up were obtained and analyzed. Primary aim of study is to analyze the hemodynamics of patients based on weight gain/loss. Secondary aim is to evaluate the same in patient-prosthesis mismatch (PPM) subgroup and to evaluate the study population for the potential to gain/loss weight.

Results

Among 118 patients, 87 patients (73.7%) gained weight. In 87 weight gained patients, left atrial (LA) size (p = 0.011) and pulmonary artery systolic (PA) pressure (p = 0.028) at follow-up were significantly elevated than the discharge values. Among 53 PPM patients (incidence, 44.9%), 34 patients gained weight and their PA pressure was found to be elevated at follow-up (p = 0.021) whereas weight lost group does not show any significant difference (p = 0.972). Frequency of weight gain was more among patients who weighed < 50 kg preoperatively (28 out of 30) (p = 0.013) and 20 to 30 years age group patients (p = 0.043). No sex predilection was noted (p = 0.149).

Conclusion

In post-MVR patients, weight gain has definitive influence over hemodynamics. In PPM subgroup, weight gained patients had significantly increased PA systolic pressure at follow-up. Young, < 50 kg weighed, and PPM patients should be advised to maintain their weight post MVR for better hemodynamics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Yock PG, Popp RL. Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation. 1984;70:657–62.

    Article  CAS  Google Scholar 

  2. Fisher MR, Forfia PR, Chamera E, et al. Accuracy of Doppler echocardiography in the hemodynamic assessment of pulmonary hypertension. Am J Respir Crit Care Med. 2009;179:615–21.

    Article  Google Scholar 

  3. Kalogeropoulos AP, Siwamogsatham S, Hayek S, et al. Echocardiographic assessment of pulmonary artery systolic pressure and outcomes in ambulatory heart failure patients. J Am Heart Assoc. 2014;3:e000363.

    Article  Google Scholar 

  4. Dumesnil JG, Honos GN, Lemieux M, Beauchemin J. Validation and applications of mitral prosthetic valvular areas calculated by Doppler echocardiography. Am J Cardiol. 1990;65:1443–8.

    Article  CAS  Google Scholar 

  5. Dumesnil JG, Yoganathan AP. Valve prosthesis hemodynamics and the problem of high transprosthetic pressure gradients. Eur J Cardiothorac Surg. 1992;6:S34–7.

    Article  Google Scholar 

  6. Hamer J, Boulton T, Fleming J, et al. Mitral valve replacement: long-term results, with particular reference to changes in pulmonary vascular resistance. Thorax. 1968;23:1–10.

    Article  CAS  Google Scholar 

  7. Mosteller RD. Simplified calculation of body surface area. N Engl J Med. 1987;317:1098.

    CAS  PubMed  Google Scholar 

  8. Anker SD, Ponikowski P, Varney S, et al. Wasting as independent risk factor for mortality in chronic heart failure. Lancet. 1997;349:1050–3.

    Article  CAS  Google Scholar 

  9. Anker SD, Sharma R. The syndrome of cardiac cachexia. Int J Cardiol. 2002;85:51–66.

    Article  Google Scholar 

  10. Pittman JG, Cohen P. The pathogenesis of cardiac cachexia. N Eng J Med. 1964;271:403–9.

    Article  CAS  Google Scholar 

  11. Palmieri V, Bella JN, Arnett DK, et al. Associations of aortic and mitral regurgitation with body composition and myocardial energy expenditure in adults with hypertension: the Hypertension Genetic Epidemiology Network study. Am Heart J. 2003;145:1071–7.

    Article  Google Scholar 

  12. Collis T, Devereux RB, Roman MJ, et al. Relations of stroke volume and cardiac output to body composition the strong heart study. Circulation. 2001;103:820–5.

    Article  CAS  Google Scholar 

  13. Buchanan N, Cane RD, Kinsley R, Eyberg CD. Gastrointestinal absorption studies in cardiac cachexia. Intensive Care Med. 1977;3:89–91.

    Article  CAS  Google Scholar 

  14. Polak J, Kotrc M, Wedellova Z, et al. Lipolytic effects of B-type natriuretic peptide 1–32 in adipose tissue of heart failure patients compared with healthy controls. J Am Coll Cardiol. 2011;58:1119–25.

    Article  CAS  Google Scholar 

  15. Rajila Rajendran HS, Seshayyan S, Victor A, Murugesan N, Sundaramurthi I. The study of mitral valve annular dimension in relation to the body surface area in the Indian population. Eur J Cardiothorac Surg. 2011;39:653–6.

    Article  Google Scholar 

  16. Kumar PV, Mundi A, Caldito G, Reddy PC. Higher body mass index is an independent predictor of left atrial enlargement. Int J Clin Med. 2011;2:556–60.

    Article  Google Scholar 

  17. Rahimtoola SH, Murphy E. Valve prosthesis--patient mismatch. A long-term sequela. Br Heart J. 1981;45:331–5.

    Article  CAS  Google Scholar 

  18. Magne J, Mathieu P, Dumesnil JG, et al. Impact of prosthesis-patient mismatch on survival after mitral valve replacement. Circulation. 2007;115:1417–25.

    Article  Google Scholar 

  19. Tuğcu A, Köse O, Yildirimtürk O, Tayyareci Y, Aytekin S. The frequency of prosthesis-patient mismatch after mechanical mitral valve replacement and its effect on postoperative systolic pulmonary arterial pressure. Turk Kardiyol Dern Ars. 2009;37:523–30.

    PubMed  Google Scholar 

  20. Li M, Dumesnil JG, Mathieu P, Pibarot P. Impact of valve prosthesis-patient mismatch on pulmonary arterial pressure after mitral valve replacement. J Am Coll Cardiol. 2005;45:1034–40.

    Article  Google Scholar 

  21. Shi WY, Yap CH, Hayward PA, et al. Impact of prosthesis--patient mismatch after mitral valve replacement: a multicentre analysis of early outcomes and mid-term survival. Heart. 2011;97:1074–81.

    Article  Google Scholar 

  22. Lam BK, Chan V, Hendry P, et al. The impact of patient-prosthesis mismatch on late outcomes after mitral valve replacement. J ThoracCardiovasc Surg. 2007;133:1464–73.

    Google Scholar 

  23. Kim SA, Kang MK, Shim CY, Lee S, Chang BC, Ha JW. Changes of body composition after valve surgery in patients with mitral valve disease. PLoS ONE. 2018;13:e0203798.

    Article  Google Scholar 

Download references

Acknowledgments

We acknowledge the statistical analysis and support provided by Dr. Porselvan, Professor, Department of Community Medicine, Saveetha Medical College. We also thank Dr. Shilpa Shree and Dr. Jeswin Moses for data collection.

Author information

Authors and Affiliations

  1. Department of Cardiac Surgery-Institute of Cardiovascular Diseases, The Madras Medical Mission, 4A, Dr. J.J. Nagar, Mogappair, Chennai, Tamil Nadu, 600037, India

    Vijayanand Palanisamy, Karthik Raman, Anjith Prakash Rajakumar, Anbarasu Mohanraj, Jacob Jamesraj, Ejaz Ahmed Sheriff, Valikapthalil Mathew Kurian & Rajan Sethuratnam

Authors
  1. Vijayanand Palanisamy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karthik Raman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anjith Prakash Rajakumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anbarasu Mohanraj
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jacob Jamesraj
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ejaz Ahmed Sheriff
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Valikapthalil Mathew Kurian
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Rajan Sethuratnam
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

• All authors listed meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors and that all authors are in agreement with the manuscript.

• All authors of this research paper have directly participated in the planning, execution, or analysis of this study.

Corresponding author

Correspondence to Vijayanand Palanisamy.

Ethics declarations

Institutional review board approval has been obtained for the publishing of patient profile and this article.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Statement of human rights

For this type of study formal consent is not required.

Conflict of interest

The authors declare that they have no competing interests.

Funding

Nil

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This study was presented at IACTS award paper presentation in IACTSCON 2019

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Palanisamy, V., Raman, K., Rajakumar, A.P. et al. Weight gain potential—a neglected entity during valve replacement. Indian J Thorac Cardiovasc Surg 36, 21–27 (2020). https://doi.org/10.1007/s12055-019-00838-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12055-019-00838-7

Keywords

Search

Navigation