Abstract
The number of obese patients undergoing cardiac and noncardiac surgery is rapidly increasing because they are more prone to concomitant diseases, such as diabetes, thrombosis, sleep-disordered breathing, cardiovascular and cerebrovascular disorders. Even if guidelines are already available to manage anesthesia and surgery of obese patients, the assessment of the perioperative morbidity and mortality from heart and brain disorders in morbidly obese surgical patients will be challenging in the next years. The present review will recapitulate the new mechanisms underlying the Heart-brain Axis (HBA) vulnerability during the perioperative period in healthy and morbidly obese patients. Finally, we will describe the nutrigenomics approach, an emerging noninvasive dietary tool, to maintain a healthy body weight and to minimize the HBA propensity to injury in obese individuals undergoing all types of surgery by personalized intake of plant compounds that may regulate the switch from health to disease in an epigenetic manner. Our review provides current insights into the mechanisms underlying HBA response in obese surgical patients and how they are modulated by epigenetically active food constituents.
Keywords: Cardioprotection, epigenetics, functional foods, neuroprotection, obesity, perioperative medicine.
[http://dx.doi.org/10.1161/CIRCRESAHA.116.308446] [PMID: 28154104]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.106.678995] [PMID: 17606855]
[PMID: 26351525]
[http://dx.doi.org/10.1136/hrt.2010.209304] [PMID: 21367742]
[http://dx.doi.org/10.1016/S0140-6736(16)31714-7] [PMID: 28088338]
[http://dx.doi.org/10.1093/bja/aeu046] [PMID: 24638232]
[http://dx.doi.org/10.3390/ijms18010129] [PMID: 28085069]
[http://dx.doi.org/10.1111/ene.13374] [PMID: 28752644]
[http://dx.doi.org/10.1002/ejhf.874] [PMID: 28560737]
[http://dx.doi.org/10.1016/j.arr.2014.07.003] [PMID: 25107566]
[http://dx.doi.org/10.1097/WAD.0b013e3181d1b99b] [PMID: 20473139]
[http://dx.doi.org/10.1007/s10741-015-9488-5] [PMID: 25896528]
[http://dx.doi.org/10.1097/MCC.0b013e328357af6d] [PMID: 22914427]
[http://dx.doi.org/10.4081/jsas.2016.6951]
[http://dx.doi.org/10.1016/j.anclin.2017.01.014] [PMID: 28526149]
[http://dx.doi.org/10.1097/EJA.0000000000000150] [PMID: 25127426]
[http://dx.doi.org/10.1097/MCC.0b013e32832e4795] [PMID: 19553809]
[http://dx.doi.org/10.1093/bja/aet059] [PMID: 23562933]
[http://dx.doi.org/10.23736/S0375-9393.18.12333-9] [PMID: 29856175]
[http://dx.doi.org/10.4238/2014.September.26.3] [PMID: 25299079]
[http://dx.doi.org/10.1016/j.bja.2017.11.012] [PMID: 29397139]
[http://dx.doi.org/10.1097/ALN.0b013e31822e9499] [PMID: 21862923]
[http://dx.doi.org/10.1159/000339982] [PMID: 22922182]
[http://dx.doi.org/10.1007/s11906-011-0195-x] [PMID: 21331606]
[http://dx.doi.org/10.1161/CIRCRESAHA.116.308407] [PMID: 28154101]
[http://dx.doi.org/10.1097/ALN.0000000000002338] [PMID: 29965817]
[http://dx.doi.org/10.1371/journal.pone.0079624] [PMID: 24236147]
[http://dx.doi.org/10.1371/journal.pone.0077637] [PMID: 24143249]
[http://dx.doi.org/10.1155/2015/370612] [PMID: 26491558]
[http://dx.doi.org/10.1213/ANE.0000000000000028] [PMID: 24413548]
[http://dx.doi.org/10.1016/j.repc.2012.12.020] [PMID: 24011864]
[http://dx.doi.org/10.1161/STROKEAHA.113.001714] [PMID: 24008571]
[http://dx.doi.org/10.1097/ACO.0000000000000336] [PMID: 27008065]
[http://dx.doi.org/10.1056/NEJMra1502824] [PMID: 26630144]
[http://dx.doi.org/10.1016/S0002-9149(96)00130-0] [PMID: 8644673]
[http://dx.doi.org/10.1002/ccd.23446] [PMID: 22419582]
[http://dx.doi.org/10.1097/ACO.0000000000000279] [PMID: 26595547]
[http://dx.doi.org/10.1016/j.athoracsur.2016.05.005] [PMID: 27372372]
[http://dx.doi.org/10.1381/096089204322857708] [PMID: 15027438]
[PMID: 8901725]
[http://dx.doi.org/10.1371/journal.pone.0118858] [PMID: 25781994]
[http://dx.doi.org/10.1053/j.jvca.2016.03.002] [PMID: 27461794]
[http://dx.doi.org/10.1001/archsurg.2011.273] [PMID: 22106323]
[http://dx.doi.org/10.1016/j.surg.2012.11.001] [PMID: 23274098]
[http://dx.doi.org/10.1161/CIR.0b013e318233bc6a] [PMID: 21947291]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.106.675355] [PMID: 17576866]
[http://dx.doi.org/10.1186/1475-2840-11-143] [PMID: 23164042]
[http://dx.doi.org/10.1017/S0029665117002014] [PMID: 28889822]
[http://dx.doi.org/10.1016/S0140-6736(04)17018-9] [PMID: 15364185]
[http://dx.doi.org/10.1038/ijo.2015.83] [PMID: 25953125]
[http://dx.doi.org/10.1177/0891988716686832] [PMID: 28077009]
[http://dx.doi.org/10.1016/j.jacc.2010.11.058] [PMID: 21545944]
[http://dx.doi.org/10.1016/j.jacc.2012.10.035] [PMID: 23369419]
[http://dx.doi.org/10.1097/SLA.0b013e3182a6605a] [PMID: 24096768]
[http://dx.doi.org/10.2310/JIM.0b013e318244e2d9] [PMID: 22257993]
[http://dx.doi.org/10.1161/ATVBAHA.114.303036] [PMID: 25147343]
[http://dx.doi.org/10.1093/qjmed/hcv201] [PMID: 26527773]
[http://dx.doi.org/10.1038/sj.ijo.0802695] [PMID: 15197408]
[http://dx.doi.org/10.1001/jama.280.21.1843] [PMID: 9846779]
[http://dx.doi.org/10.1097/SLA.0b013e31823dcbf7] [PMID: 22190113]
[http://dx.doi.org/10.1177/1538574411415427] [PMID: 21788282]
[http://dx.doi.org/10.1001/jama.293.15.1861] [PMID: 15840860]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.116.022840] [PMID: 28034901]
[http://dx.doi.org/10.1001/archinternmed.2010.201] [PMID: 20696950]
[http://dx.doi.org/10.1001/archsurg.2011.310] [PMID: 22106249]
[http://dx.doi.org/10.1111/jgs.14786] [PMID: 28248413]
[http://dx.doi.org/10.1097/SLA.0b013e3181ad8935] [PMID: 19561456]
[http://dx.doi.org/10.3109/17453674.2014.934184] [PMID: 24954493]
[http://dx.doi.org/10.1016/S1474-4422(17)30084-4] [PMID: 28504110]
[http://dx.doi.org/10.1097/ALN.0000000000001515] [PMID: 28121636]
[http://dx.doi.org/10.1038/nature05482] [PMID: 17167471]
[http://dx.doi.org/10.3389/fendo.2012.00181] [PMID: 23316186]
[http://dx.doi.org/10.1677/joe.0.1810419] [PMID: 15171690]
[PMID: 10946012]
[http://dx.doi.org/10.1074/jbc.M411226200] [PMID: 15805118]
[http://dx.doi.org/10.1038/s41366-018-0005-5] [PMID: 29449623]
[http://dx.doi.org/10.1056/NEJMoa065213] [PMID: 17429083]
[http://dx.doi.org/10.1172/JCI0214955] [PMID: 12021247]
[http://dx.doi.org/10.1152/ajpendo.00087.2001] [PMID: 11788371]
[http://dx.doi.org/10.1056/NEJMra065156] [PMID: 17429086]
[http://dx.doi.org/10.1016/j.bjan.2017.04.017] [PMID: 28571661]
[http://dx.doi.org/10.1038/nrcardio.2010.223] [PMID: 21283149]
[http://dx.doi.org/10.1152/ajpregu.00523.2012] [PMID: 23576615]
[http://dx.doi.org/10.1097/MD.0000000000004791] [PMID: 27603384]
[http://dx.doi.org/10.1371/journal.pone.0024783] [PMID: 21966368]
[PMID: 1431589]
[http://dx.doi.org/10.1016/j.bbalip.2011.10.003] [PMID: 22005032]
[http://dx.doi.org/10.1194/jlr.R200017-JLR200] [PMID: 12639974]
[http://dx.doi.org/10.1042/bst0311066] [PMID: 14505481]
[http://dx.doi.org/10.1186/1476-511X-10-176] [PMID: 21988829]
[http://dx.doi.org/10.2337/diacare.19.6.629] [PMID: 8725863]
[http://dx.doi.org/10.1111/j.0954-6820.1969.tb07347.x] [PMID: 5806343]
[http://dx.doi.org/10.1016/j.vph.2012.05.003] [PMID: 22609131]
[http://dx.doi.org/10.2337/db10-0867] [PMID: 20943748]
[http://dx.doi.org/10.3109/07435800.2010.534751] [PMID: 21226563]
[http://dx.doi.org/10.2337/diabetes.47.6.953] [PMID: 9604874]
[http://dx.doi.org/10.3390/nu8020054] [PMID: 26891317]
[http://dx.doi.org/10.1038/nature05487] [PMID: 17167476]
[http://dx.doi.org/10.1093/gerona/glw070] [PMID: 27075896]
[http://dx.doi.org/10.1097/ALN.0b013e318286d0c9] [PMID: 23353794]
[http://dx.doi.org/10.1056/NEJMoa1507750] [PMID: 27144849]
[http://dx.doi.org/10.1161/JAHA.117.008054] [PMID: 29275377]
[http://dx.doi.org/10.1161/JAHA.116.004199] [PMID: 28275071]
[http://dx.doi.org/10.1177/0003319718774660] [PMID: 29739239]
[http://dx.doi.org/10.1155/2015/256905] [PMID: 26090394]
[http://dx.doi.org/10.1002/jcla.20416] [PMID: 21089169]
[http://dx.doi.org/10.1093/bja/aet354] [PMID: 24172055]
[http://dx.doi.org/10.1536/ihj.17-143] [PMID: 29681567]
[PMID: 31808661]
[http://dx.doi.org/10.1038/srep30048] [PMID: 27443965]
[http://dx.doi.org/10.1139/cjpp-2017-0126] [PMID: 28715643]
[http://dx.doi.org/10.1093/europace/euv354] [PMID: 26566941]
[http://dx.doi.org/10.1016/j.ijcard.2016.05.002] [PMID: 27179208]
[PMID: 8118478]
[http://dx.doi.org/10.1098/rstb.2011.0337] [PMID: 23166398]
[http://dx.doi.org/10.1139/cjpp-2012-0392] [PMID: 23889534]
[http://dx.doi.org/10.3945/an.113.004705] [PMID: 24425725]
[http://dx.doi.org/10.2174/1389450116666150630110821] [PMID: 26122032]
[http://dx.doi.org/10.1186/s13148-017-0365-z] [PMID: 28670349]
[http://dx.doi.org/10.1080/10408390903372599] [PMID: 19960394]
[http://dx.doi.org/10.1038/cr.2007.48] [PMID: 17563755]
[http://dx.doi.org/10.1186/1741-7007-7-38] [PMID: 19589179]
[http://dx.doi.org/10.1038/nature07777] [PMID: 19194461]
[http://dx.doi.org/10.1016/j.cardiores.2005.02.004] [PMID: 15914110]
[http://dx.doi.org/10.1152/ajpheart.00592.2007] [PMID: 17704291]
[http://dx.doi.org/10.1016/j.cardfail.2009.06.436] [PMID: 19944370]
[http://dx.doi.org/10.1111/jcmm.12198] [PMID: 24444256]
[http://dx.doi.org/10.1124/jpet.106.116871] [PMID: 17215446]
[http://dx.doi.org/10.1093/nar/gkq132] [PMID: 20215437]
[http://dx.doi.org/10.1186/1868-7083-4-10] [PMID: 22748066]
[http://dx.doi.org/10.1289/ehp.1103423] [PMID: 21669556]
[http://dx.doi.org/10.1016/j.bbi.2011.01.017] [PMID: 21296655]
[http://dx.doi.org/10.1038/oby.2009.474] [PMID: 20057369]
[http://dx.doi.org/10.3390/ijms19010066] [PMID: 29280944]
[http://dx.doi.org/10.1038/s41598-018-26065-5] [PMID: 29769661]
[http://dx.doi.org/10.1016/j.neuroscience.2015.04.045] [PMID: 25934036]
[http://dx.doi.org/10.1016/j.psyneuen.2014.01.020] [PMID: 24636513]
[http://dx.doi.org/10.1111/bph.12865] [PMID: 25073649]
[http://dx.doi.org/10.1016/j.pain.2012.06.011] [PMID: 23273101]
[http://dx.doi.org/10.1093/bja/aes128] [PMID: 22542536]
[http://dx.doi.org/10.1097/SLA.0b013e31805dac11] [PMID: 17667496]
[http://dx.doi.org/10.3746/pnf.2015.20.1.1] [PMID: 25866743]
[http://dx.doi.org/10.1016/j.clnu.2017.11.014] [PMID: 29233588]
[http://dx.doi.org/10.1038/cdd.2014.200] [PMID: 25501599]
[http://dx.doi.org/10.1038/ng.274] [PMID: 19079260]
[http://dx.doi.org/10.1016/j.neuropsychologia.2014.10.004] [PMID: 25447070]
[http://dx.doi.org/10.1016/j.nlm.2012.04.005] [PMID: 22542746]
[http://dx.doi.org/10.1523/JNEUROSCI.1934-15.2016] [PMID: 26818519]
[http://dx.doi.org/10.1016/bs.pmbts.2016.12.016] [PMID: 28253987]
[http://dx.doi.org/10.1161/CIRCRESAHA.117.305109] [PMID: 26089364]
[http://dx.doi.org/10.1111/jcmm.12556] [PMID: 25782072]
[http://dx.doi.org/10.1016/j.bbadis.2016.07.020] [PMID: 27479696]
[http://dx.doi.org/10.1002/jcb.25902] [PMID: 28109123]
[http://dx.doi.org/10.3390/nu6115338] [PMID: 25421534]
[http://dx.doi.org/10.1080/10408398.2011.629354] [PMID: 24499150]
[http://dx.doi.org/10.1001/jama.2009.1146] [PMID: 19671905]
[http://dx.doi.org/10.1186/1471-244X-13-175] [PMID: 23802679]
[http://dx.doi.org/10.1056/NEJMoa1800389] [PMID: 29897866]
[http://dx.doi.org/10.3390/nu10010015] [PMID: 29295516]
[http://dx.doi.org/10.1155/2016/7857186] [PMID: 26881038]
[http://dx.doi.org/10.17756/nwj.2017-s2-003]
[http://dx.doi.org/10.3389/fnagi.2017.00121] [PMID: 28507518]
[http://dx.doi.org/10.2174/1389450116666150304103517] [PMID: 25738298]
[http://dx.doi.org/10.1111/1755-5922.12277] [PMID: 28636290]
[http://dx.doi.org/10.1016/j.yjmcc.2013.01.008] [PMID: 23353773]
[http://dx.doi.org/10.1038/srep30252] [PMID: 27457280]
[http://dx.doi.org/10.1371/journal.pone.0094228] [PMID: 24796753]
[http://dx.doi.org/10.1016/j.jnutbio.2015.06.006] [PMID: 26298192]
[http://dx.doi.org/10.1371/journal.pone.0165406] [PMID: 27780234]
[http://dx.doi.org/10.1002/mnfr.201600194] [PMID: 27735126]
[http://dx.doi.org/10.1155/2018/1617202] [PMID: 29576843]
[http://dx.doi.org/10.1371/journal.pone.0163716] [PMID: 27832073]
[http://dx.doi.org/10.1148/radiol.12112723] [PMID: 22843766]
[http://dx.doi.org/10.1158/1055-9965.EPI-11-0279] [PMID: 21602309]
[http://dx.doi.org/10.1016/j.phymed.2006.09.013] [PMID: 17084602]
[http://dx.doi.org/10.1016/j.jaci.2008.01.016] [PMID: 18325578]
[http://dx.doi.org/10.1371/journal.pone.0036216] [PMID: 22558388]
[http://dx.doi.org/10.1172/JCI32865] [PMID: 18292803]
[http://dx.doi.org/10.1111/j.1476-5381.2012.02109.x] [PMID: 22823335]
[http://dx.doi.org/10.1139/cjpp-2013-0055] [PMID: 23984717]
[http://dx.doi.org/10.1155/2014/898361] [PMID: 24678280]
[http://dx.doi.org/10.1371/journal.pone.0140431] [PMID: 26473740]
[http://dx.doi.org/10.1016/j.bbr.2012.10.049] [PMID: 23142609]
[http://dx.doi.org/10.1371/journal.pone.0131525] [PMID: 26114940]
[http://dx.doi.org/10.1089/scd.2006.15.165] [PMID: 16646663]
[http://dx.doi.org/10.1371/journal.pone.0103067] [PMID: 25051175]
[http://dx.doi.org/10.1023/A:1010619128894] [PMID: 11554481]
[http://dx.doi.org/10.1017/S000711451600341X] [PMID: 27724985]
[http://dx.doi.org/10.1016/j.nut.2017.05.002] [PMID: 28870472]
[PMID: 3037453]
[http://dx.doi.org/10.1111/j.1753-4887.2012.00494.x] [PMID: 22835138]
[http://dx.doi.org/10.1111/jcmm.12442] [PMID: 25388628]
[http://dx.doi.org/10.1016/j.ijcard.2013.03.015] [PMID: 23561919]
[http://dx.doi.org/10.1152/ajprenal.00122.2011] [PMID: 21816757]
[http://dx.doi.org/10.1038/s41598-017-13949-1] [PMID: 29044182]
[http://dx.doi.org/10.1016/S1734-1140(13)71031-4] [PMID: 23950576]
[http://dx.doi.org/10.7150/thno.19824] [PMID: 28656059]
[http://dx.doi.org/10.3181/0711-MR-311] [PMID: 18408140]
[http://dx.doi.org/10.1007/s13105-013-0265-4] [PMID: 23794360]
[http://dx.doi.org/10.1007/s00394-017-1453-8] [PMID: 28488130]
[http://dx.doi.org/10.3390/nu8030128] [PMID: 26950145]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.114.010236] [PMID: 25161045]
[http://dx.doi.org/10.1038/tp.2017.190] [PMID: 28850110]
[http://dx.doi.org/10.1007/s00394-015-0889-y] [PMID: 25820817]
[http://dx.doi.org/10.3945/ajcn.112.037432] [PMID: 23034965]
[http://dx.doi.org/10.1016/j.nut.2013.09.013] [PMID: 24342530]
[http://dx.doi.org/10.1017/S0007114511004788] [PMID: 21929835]
[http://dx.doi.org/10.3390/nu9080865] [PMID: 28800093]
[http://dx.doi.org/10.1038/srep25867] [PMID: 27181711]
[http://dx.doi.org/10.1371/journal.pone.0109896] [PMID: 25329159]
[http://dx.doi.org/10.1038/ejhg.2014.139] [PMID: 25074463]
[http://dx.doi.org/10.1016/j.nbd.2014.09.014] [PMID: 25283985]
[http://dx.doi.org/10.1186/s13148-017-0345-3] [PMID: 28450971]
[http://dx.doi.org/10.1001/jama.2011.1435] [PMID: 21976613]
[http://dx.doi.org/10.1186/s13613-017-0282-5] [PMID: 28585162]
[http://dx.doi.org/10.1186/s13054-015-0888-7] [PMID: 25879776]
[http://dx.doi.org/10.1186/s12937-017-0245-6] [PMID: 28427403]
[http://dx.doi.org/10.1016/j.clnu.2016.05.013] [PMID: 27293143]
[http://dx.doi.org/10.1016/j.cmi.2015.07.003] [PMID: 26197212]
[http://dx.doi.org/10.1016/j.yjmcc.2018.01.017] [PMID: 29409987]
[http://dx.doi.org/10.1186/s13054-017-1690-5] [PMID: 28583157]
[http://dx.doi.org/10.1007/s40140-017-0245-2] [PMID: 29200973]
[http://dx.doi.org/10.1177/0884533611418336] [PMID: 21947635]
[http://dx.doi.org/10.1053/j.jvca.2017.11.020] [PMID: 29306619]
[http://dx.doi.org/10.1126/science.1227166] [PMID: 23223453]
[http://dx.doi.org/10.2174/09298673113209990189] [PMID: 23895687]
[http://dx.doi.org/10.1038/ijo.2014.213] [PMID: 25520250]
[http://dx.doi.org/10.1007/s11695-012-0790-1] [PMID: 23086524]