Influence of cholecystectomy on heart condition, lipid metabolism and inflammation activity

Abstract

Aim. Gallbladder disorders and ischemic heart disease share common etiopathogenetic factors of development and influence each other. Literature describes dependence of clinical presentation of ischemic heart disease on gallbladder condition, and improvement of heart condition after cholecystectomy. The aim of this study was to compare features of the heart condition, lipid metabolism parameters, inflammation activity, and their correlations in patients with ischemic heart disease after cholecystectomy and with different gallbladder conditions. Materials and Methods. We analyzed data of 197 patients with ischemic heart disease (namely, stable and unstable angina pectoris), which were diagnosed and treated according to the existing guidelines. These patients were divided into 6 groups: with intact gallbladder; with sludge, bile thickening, polyps, and cholesterosis; with bent gallbladder body and its deformations; with gallbladder neck deformations and signs of past cholecystitis; with cholelithiasis; and after cholecystectomy. Results and Discussion. It was revealed that cholecystectomy in chronic subtypes of ischemic heart disease was associated with minimal frequency of arrhythmias, and in acute subtypes - with maximal frequency. Structural and functional parameters of the heart were the best in patients with a history of cholecystectomy. This was reflected in the smallest sizes of the right ventricle (2.31 cm), the left atrium (3.95 cm), and the left ventricle (4.92 cm), along with the smallest thickness of the interventicular septum (1.14 cm) and the posterior wall of the left ventricle (1.11 cm). The patients with removed gallbladder were characterized by the lowest values of total cholesterol (4.41 mmol/L), triglycerides (1.37 mmol/L), cholesterol of low density lipoproteins (2.61 mmol/L) and the atherogenic index of plasma (2.77) among all the groups with different gallbladder condition. All the parameters were lower than the parameters of intact gallbladder group. Both Castellі indexes after cholecystectomy were lower than in the group with intact gallbladder. Conclusions. The patients with a history of cholecystectomy were characterized by better parameters of lipid metabolism than patients of the other groups with different gallbladder conditions. The cholecystectomy group was characterized by the lowest inflammation activity according to the band neutrophils count (1.77%), the neutrophils to lymphocytes ratio (3.01), and the total fibrinogen level (4.03 g/L). Key words: ischemic heart disease, cholecystectomy, echocardiography, gallbladder, lipidogram