Diastolic Dysfunction in Morbidly Obese Patients Undergo Bariatric Surgery

Study Overview
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Brief Summary
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Morbidly obese patients are at risk for diastolic cardiac dysfunction, which can lead to adverse event, such as, diastolic heart failure postoperatively. Preoperative screening by transthoracic echocardiogram is difficult due to anatomical challenge, therefore the prevalence of this problem may be underestimated. The investigator would like to perform transesophageal echocardiogram in this group of patients after anesthesia induction to demonstrate the true prevalence of this syndrome.

Detailed Description
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Morbidly obese patients are at risk for both respiratory and cardiovascular abnormalities. Many cardiac problems were previously reported including left ventricular hypertrophy, right and left ventricular systolic dysfunction etc. Diastolic cardiac dysfunction can be found in normal left ventricular systolic function and can lead to diastolic heart failure postoperatively. Preoperative screening by transthoracic echocardiogram is difficult due to anatomical challenge (thick chest wall, narrowing of inter-rib space), therefore the prevalence of this problem may be underestimated. Transesophageal echocardiogram provides better cardiac view, but requires sedation during procedure. So, it is not practical for out-patient setting. The investigator would like to perform transesophageal echocardiogram in this group of patients after anesthesia induction to demonstrate the true prevalence of this syndrome.

Official Title
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The Prevalence of Diastolic Dysfunction in Morbidly Obese Patients Undergo Bariatric Surgery

Conditions
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Diastolic Dysfunction, Morbid Obesity

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Every patient scheduled for bariatric surgery in Siriraj hospital Exclusion Criteria: Patient refusal patient with contraindication for transesophageal echocardiogram such as preexisting esophageal disease, recent upper gastrointestinal bleeding, coagulopathy, etc. (according to American society of Echocardiography guideline)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of diastolic dysfunction | Prevalence of diastolic dysfunction according to American society of echocardiography definition | during surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of other cardiac abnormalities | Number of patients with other cardiac abnormalities, both structural and functional abnormalities | during surgery | 
| Incidence of cardiac adverse events | Number of patients with cardiac adverse event: myocardial ischemia, pulmonary edema | within 24 hours after surgery | 
| Incidence of pulmonary adverse events | Number of patients experienced aspiration, desaturation, re-intubation | within 24 hours after surgery | 
| Incidence of oral and airway trauma | Number of patients with new loose teeth, sore throat, difficult to swallow, hoarseness of voice | within 24 hours after surgery | 
| Length of hospital stay | duration of hospital stay | up to 5 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Diastolic dysfunction, Morbid Obesity, Bariatric surgery