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Previous issue date: 2018-02-26 / Introduction: Obesity is one of the most important nutritional diseases in the modern world, especially in its abdominal form, where adipose tissue implies a higher cardiovascular risk and is responsible for inflammatory phenomena. Abdominal obesity predisposes to calcification of the coronary arteries and endothelial dysfunction, as well as the occurrence of other comorbidities such as hypertension diabetes and Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). OSAHS leads to decreased quality of life (QOL) and functional capacity, together with an increased risk of cardiovascular disease, predisposing to higher rates of morbidity and mortality. Objectives: To evaluate the impact of weight loss in the first six months after bariatric surgery on endothelial function in patients with and without obstructive sleep apnea syndrome (OSAHS). Methodology: the sample consisted of 56 patients homogeneously divided into groups without OSAHS (control group) and with OSAHS (OSAHS). All patients were evaluated in the Roux-en-Y Gastric Bypass (RYGB) preoperative period and six months after surgery. OSAHS diagnosis in the preoperative period was performed using instruments validated for apnea tracking and confirmed by polysomnography. The evaluations included anthropometric measurements, electrical bioimpedance, clinical symptoms of OSAHS and endothelial function, through the flow-mediated dilatation (FMD) of the brachial artery. Results: weight loss induced by surgery improved the anthropometric, bioimpedance and endothelial function results in both groups. Patients presented a significant clinical improvement in the symptoms of OSAHS throughout the study. However, patients with OSAHS had an improvement in the endothelial function 2.5% lower (p <0.001) than the control group. Conclusion: this study shows that the presence of OSAHS before bariatric surgery interferes in the clinical picture, interfering in the improvement of endothelial function. / Introdu??o: a obesidade ? uma das doen?as nutricionais mais importantes do mundo moderno, principalmente, em sua forma abdominal, onde o tecido adiposo implica em maior risco cardiovascular e ? respons?vel por fen?menos inflamat?rios. A obesidade abdominal predisp?e ? calcifica??o das art?rias coron?rias e ? disfun??o endotelial, bem como ao aparecimento de outras comorbidades como a hipertens?o, a diabetes e a S?ndrome da Apneia Hipopneia Obstrutiva do Sono (SAHOS). A SAHOS leva ? diminui??o da qualidade de vida (QV) e da capacidade funcional, juntamente com um risco aumentado de doen?a cardiovascular, predispondo a maiores ?ndices de morbidade e mortalidade. Objetivos: avaliar o impacto da perda de peso ocorrida nos primeiros seis meses ap?s a realiza??o da cirurgia bari?trica sobre a fun??o endotelial em pacientes, com e sem s?ndrome da apneia hipopneia obstrutiva do sono (SAHOS). Metodologia: a amostra foi composta por 56 pacientes homogeneamente divididos em grupos sem SAHOS (grupo controle) e com SAHOS (SAHOSG). Todos os pacientes foram avaliados no pr?-operat?rio do Bypass G?strico em Y de Roux (RYGB) e seis meses ap?s a cirurgia. O diagn?stico de SAHOS no pr?-operat?rio foi realizado atrav?s dos instrumentos validados para rastreamento de apneia e confirmados por polissonografia. As avalia??es compreenderam medidas antropom?tricas, bioimped?ncia el?trica, sintomas cl?nicos de SAHOS e fun??o endotelial, pela dilata??o mediada pelo fluxo (FMD) da art?ria braquial. Resultados: o emagrecimento induzido pela cirurgia melhorou os resultados antropom?tricos, da bioimped?ncia e da fun??o endotelial em ambos os grupos. Os pacientes apresentaram uma sens?vel melhora cl?nica nos sintomas da SAHOS ao longo do estudo. Entretanto, os pacientes com SAHOS, apresentaram uma melhora na fun??o endotelial 2,5% menor (p< 0.001) que o grupo controle. Conclus?o: Este estudo demostrou que a presen?a de SAHOS, previamente ? cirurgia bari?trica, interfere no quadro cl?nico e na melhora da fun??o endotelial.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/8052 |
| Date | 26 February 2018 |
| Creators | Machado, Ana Cristina de Assun??o |
| Contributors | Mottin, Cl?udio Cor?, Silva, Antonio Marcos Vargas da |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 500, 500, 500, -224747486637135387, -969369452308786627 |
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