Kuwedzera muviri kune chikonzero chekutengesa kwekushaya simba kwemoyo saka kuora mwoyo kunotanga kunogona kubatsira kudzivirira mwoyo kusakatika gare gare. Asi zvakadini nezvekuvhiya kunoenda kunorema kurasikirwa, sekuvhiyiwa kwainzi bariatric (kuvhiya kurasikirwa kwekureruka) uye maitiro ekurasikirwa-kurasikirwa kwemajeri ? Izvo zvinogona kudzivirira mwoyo kusakundikanawo here? Kutsvakurudza kunojekesa pane izvi.
Kuneta uye Mwoyo Wezvirwere
Kuwedzera muviri uye kuwandisa kune mamiriro ezvinhu ari, zvinosuruvarisa, zvinokonzera njodzi yekuvandudzwa kwemhando dzakasiyana -siyana dzehutano hwemwoyo dzinosanganisira kuwedzera kweropa, kushaya mwoyo, kushaya ropa , kuora mwoyo, uye kushaya mwoyo.
Kuwedzera muviri kunewo chikonzero chinonyatsozivikanwa chechirwere cheshuga chechipiri , chiri mukati maro uye pachacho chakanyanya kukonzerwa nehutachiona hwehutano hwemwoyo. Uye kuneta kunokonzera cholesterol yakakwirira, iyo iriwo chikonzero chinonyatsozivikanwa chechifo chemoyo.
Uyezve, kurema kunokonzerwa nehutano hwemwoyo usinganzwisisiki rhythm inozivikanwa seAriric fibrillation, uye vanhu vane acrial fibrillation vari pangozi yekurohwa. Kuwedzera muviri kunogona kukanganisa zvakawanda zvehupenyu hwemwoyo.
Sezvakataurwa pamusoro apa, pane nzira dzakawanda dzinokonzerwa nekuninipisa kune imwe mamiriro ezvinhu akasiyana-siyana emwoyo, asi zvakakoshawo kuyeuka kuti kuneta kunowedzera kuputika mumuviri wose, uye kuvhiringidza kunogonawo kuita basa muhutano hwemwoyo.
Kuneta uye Mwoyo Kukundikana
Kutanga kubva, chii chinokanganisa moyo? Zvichinyorwa, kune maviri emhando huru yekushaya mwoyo : systolic moyo kusakatika uye diastolic mwoyo kusakundikana.
Mu systolic moyo kusakundikana, mwoyo unokundikana kupomha kazhinji; izvi zvinosanganiswa nechikamu chiduku che ejection (chiyero chepombi rinoshanda).
Mu diastolic mwoyo kusakatika (ikozvino ichangobva kuzivikanwa sepfungwa kusagadzikana nekachengetedzwa chikamu chejasi), kachikamu ka ejection kazhinji, asi mwoyo hauchiri kuputika kazhinji nekuda kwemwoyo wemisungo yakaoma kwazvo.
Zvose systolic uye diastolic mwoyo kusakwanisa kune zvikonzero zvakasiyana-siyana, uye kunyange kugovana zvimwe zvinokonzera, zvakadai sokukwirira kweropa, chirwere chetachiona cheutachiona, nekuwedzerwa .
Mhando ipi zvayo yekusagadzikana kwemoyo inogona kutungamirira kune zviratidzo zveinozivikanwa se congestive moyo kusakundikana, umo mvura inotonhora inowedzera mumapapu, zvichiita kuti zviome kufema; Mvura inogonawo kuwedzera mumakumbo, zvichiita kuti kuve nekudzikama uye kusagadzikana.
Saka, mumoyo wekukundikana, mwoyo haukwanise kupomha kazhinji kana kubudirira kuchengetedza kukwira kwakakwana mumuviri wose.
Saka kuneta kunorevei nekunetseka kwemoyo? Muchirevo chekushaya mwoyo kusunungurwa muna 2013 neAmerican College of Cardiology Foundation neAmerican Heart Association, kuneta kunofungidzirwa sechinhu chekutanga chekushaya mwoyo.
Iyi nhungamiro inorondedzera kuneta sechiremba chinogona, pacharo, kuisa munhu muChikamu A chekushaya mwoyo. Nhanho A, sezvinotsanangurwa nehutungamiri hwenyika ino, inosanganisira vose avo vari "pangozi yekutadza kwemoyo asi vasina chirwere chemwoyo kana zviratidzo zvekushaya mwoyo." Izvi zvinoreva kuti, kunyange zvazvo munhu ane hutano husingave ane zviratidzo kana zviratidzo zvemoyo kusakundikana, ivo vachiri kufungidzirwa kuti vari panotangira danho rekushaya simba kwemoyo chete nekuda kwekuve nekuneta.
Izvi zvinopa chirevo chakasimba pamusoro pekukosha kwekurapa kuneta kwepamusoro kudzivisa kuora mwoyo mwoyo kusakundikana.
Bariatric Surgery Yakagadzirirwa Kudzivisa Mwoyo Kukundikana
Nenzira yakanaka, kuora-kurasikirwa kwekuita kunobhadhara, uye kana uine kuneta unogona kuita matanho makuru ekudzivirira hutano hwehutano, kusanganisira mwoyo kusakundikana, nokurasika. Kunyangwe zvishoma zvishoma nekurasikirwa, mukati memazana mashanu kusvika kune gumi muzana yehuwandu hunorema, zvinogona kuita kusiyana kukuru.
Uye zvino zvidzidzo zvakawana kuti kurasikirwa kwemazivi kuburikidza nekuvhiyiwa, kusanganisira nzira dzakadai sechikafu chechikafu , sleeve gastrectomy, uye lap banding , zvinogonawo kudzivirira chirwere chepfungwa chinokanganisa mwoyo.
Pakazosvika 2016 American Heart Association Scientific Sessions, vatsvakurudzo vakatungamirirwa nemunyori mukuru John Sundstrom, MD, PhD, purofesa we epidemiology kuUppsala University kuSweden, akaratidza migumisiro yekudzidza kukuru (yevanenge vanenge 40 000 varwere vose) vakaona kuti varwere nekuninipiswa kwakange kwave kusangana nekuvhiyiwa kwevanaatric kwakanga kusingagoni kunyanya kukanganisa mwoyo kune avo vasina kumbovhiyiwa asi panzvimbo pekuedza kuchinja mararamiro ehupenyu sekudya kwakasimba uye kuitisa muviri.
Vatsvakurudzi vanotaura kuti zvinokonzera kushanda kwekuropwa kwebhanati kunogona kuve nekuda kwekuita chirwere chemaitiro anozivikanwa pakugadzirisa njodzi zvinokonzerwa nekushaya mwoyo, zvakadai seshuga, kukwidziridzwa kweropa, uye kushaya firati.
Semuenzaniso, mune chidzidzo chakaitwa naJamaly uye vashandi pamwe chete uye chakabudiswa mu Journal of the American College of Cardiology munaDisemba 2016, vanyori vakaona kuti "kana tichienzaniswa nekuchengetedzwa kwemazuva ose, kushaya kurasikirwa kuburikidza nekuvhiyirwa kwaBaratric kwakaderedza dambudziko rekushaya firipi mukati mevanhu yakarapwa nokuda kwekuneta zvakanyanya. "Zvinofadza kuti izvi zvinopedzisira zvichinyanya kuzivikanwa muvanhu vaduku uye kune vanhu vanoremerwa neropa.
Izvi zvakakoshawo kuziva kuti chirongwa chebhaatric chinogona kuguma nekurasikirwa kukuru kwehupfumi pamusoro penguva pfupi, sezvakaonekwa muDkt. Sundstrom's study, umo, negore rimwe mushure mekuvhiyiwa, varwere vakange varasikirwa nereji yemapirogiramu makumi mana kupfuura avo vakashandisa nzira yehupenyu chete inoshandiswa (asi hapana kuvhiyiwa).
Muchikamu chikuru nekuda kwechirongwa ichi chekurumidza kurasikirwa kwepamusoro pane nguva shomanana, chirwere chemahara chinowanika mune zvidzidzo zvakawanda kuti zviite kuti kuderera kukuru kuwedzerwa kwechirwere cheshuga uye kuwedzerwa kweropa, izvo zvinowedzera kukanganisa kwehutano hwemwoyo ( sezvo zvose chirwere cheshuga uye kukwirira kweropa zvakakonzera zviitiko zvehutano hwepfungwa).
Uri Mudiwa weBariatric Surgery?
Saka, iwe unogona kunge uchishamisika kana iwe uri mukana wekuvhiya ye-bariatric. Ramba uchiyeuka kuti kune marudzi akasiyana-siyana ezvokudya-kurasikirwa, asi mazhinji emitemo iyi ine zvimwe zvakakodzera zvinodiwa.
Maererano nehutachiona hutsva hunotungamirirwa neAmerican Heart Association (AHA), American College of Cardiology (ACC), uye The Obesity Society (TOS), chirwere chemaitiro chinogona kuve sarudzo kuvarwere vakura vanosangana nedzimwe nzira.
Izvi zvinosanganisira muviri mashoma index (BMI) ye 40 kana kupfuura, kana BMI ye 35 kana mukuru kune mumwe murwere ane zvimwe zvirwere (zvinonzi "comorbid conditions") zvinokonzerwa nokuneta. Kuwedzera kwekuwedzera kwekutungamirirwa komiti hauna kuwana hukwani hwakakwana hwokurudzira chirongwa chemajeri kune varwere vane BMIs vanowa pasi pematsetse aya.
Nhungamiro iyi inokurudzira vanachiremba vanonyanya kutarisira uye vamwe vanotarisira varwere vane hutano hwakanyanya nepamusoro BMI kuedza "kurapa maitiro kana pasina pharmacotherapy" kutanga, uye zvino kana izvi zvisati zvashanda pamwe chete nezvimwe kudya uye mararamiro emitambo yekuwana kukwana kurasikirwa kwakakwana, bariatric kuvhiyiwa kunogona kufungwa.
Saka zvakakosha kuti ukurukure izvi nechiremba wako, ndiani angakubatsira iwe kusarudza kana iwe uri mumiririri akanaka kune chirongwa chebhinzi uye, kana iwe uri, nzira ipi ichaita iwe.
Dzimwe Nzira Dzakakwanisa Kuderedza Dambudziko Renyu Pamwoyo Wezvirwere
Mukuwedzera pakurasikirwa nekurema, kune dzimwe nzira dzakawanda dzinokosha umo iwe unogona kuderedza dambudziko rako rehutano hwemwoyo muhupenyu uye nekushaya simba kwemoyo kunyanya.
Chokutanga, ziva nhamba dzako. Izvi zvinoreva kuwana cholesterol yako kuongororwa, ropa rako rinotaridzirwa, uye shuga yako yeropa inotarirwa kuti isati yaita chirwere cheshuga kana chirwere cheshuga. Kutora hutano hwako kunosanganisira kuziva kwaunotanga kubva, kuitira kuti iwe uzive kuti ndezvipi zvinokonzerwa nehupenyu hwako uye uite chimwe nechimwe kuti uderedze njodzi yako yose.
Sezvinoitika, zvakawanda zvehupenyu hunochinja hunochengetedza zvose izvi zvinowanzoisa pangozi zvakafanana, uye zvichakubatsira kuchengetedza uremu hutano, zvakare. Kutungamira mararamiro ehupenyu hune utano zvinoreva kuwana zuva rekuita muviri uye kutevera tsika dzakanaka dzekudya .
Imwe nzira yekudya, kunyanya, yakaratidzwa, nguva nenguva, kwemazana makumi emakore ekutsvakurudza, kudzivirira chirwere chemwoyo, uye iyo ndiyo kudya kweMediterranean.
Panzvimbo pokuva kudya kwefadhi iyo inosarudzira chete zvinangwa zvenguva pfupi yekurasikirwa nekurema, kudya kweMediterranean ndiko kusarudza mararamiro, nzira yekudya kwehupenyu hwose. Iyi ndiyo nzira yekudya yevakawanda vevagari vemunyika dzakapoteredza Gungwa reMediterranean-saka zita racho.
Kudya kweMediterranean kunotsanangura kushandiswa kwemichero yose nemiriwo , zviyo zvose, marimu emiti, mamwe mazamu anodiwi omuorivhi, hove uye huku, newaini (kunyanya waini tsvuku) mukuenzanisa.
Sezvo bhonasi yakawedzerwa, kudya kweMediterranean kwakawanikwawo kunobatsira kurerutsa uye kuve pangozi yepamusoro yekenza yemazamu .
> Sources:
Estruch R, Ros E, Salas-Salvadó J, et al. Kunyanya kudzivirira kwehutano hwepfungwa neMediterranean. N Engl J Med 2013; 368: 1279-1290.
> Jamaly S, Carlsson L, Peltonen M, Jacobson P, et al. Bariatric operesheni uye njodzi yekutsvaga kwemazuva ekutapuka kwepanyama muSweden zvakanyanya kutongwa. J Am Coll Cardiol. 2016; 68: 2497-2504.
> Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA / ACC / TOS nhungamiro yehutungamiri hwehuwandu hwehuwandu hwehuwandu hwevanhu nekurema kwevanhu vakuru: mushumo weAmerican College of Cardiology / American Heart Association Task Force pamitungamiri yeOkudzidzira uye The Obesity Society [yakabudiswa paIndaneti Musi wa27, 2013]. J Am Coll Cardiol.
> Sundstrom J, Bruze G, Ottosson J, Marcus C, et al. American Heart Association Scientific Sessions 2016. Bhuku (poster session) rakaratidzwa kurarama musi waNovember 14, 2016.
> Yancy CW, Jessup M. Bozkurt B, Butler J, et al. 2013 ACCF / AHA mutungamiri wehutungamiri hwekushushikana kwemoyo: mushumo weAmerican College of Cardiology Foundation / American Heart Association Task Force pamusoro pekushandisa mazano. Circulation 2013 Jun 5 [Epub mberi kwekudhinda].