TY - JOUR
T1 - Weight loss after bariatric surgery significantly improves carotid and cardiac function in apparently healthy people with morbid obesity
AU - Giudici, Alessandro
AU - Palombo, Carlo
AU - Kozakova, Michaela
AU - Morizzo, Carmela
AU - Losso, Lorenzo
AU - Nannipieri, Monica
AU - Berta, Rossana
AU - Hughes, Alun D.
AU - Cruickshank, John Kennedy
AU - Khir, Ashraf W.
N1 - Funding Information:
This project was funded by the Italian Ministry of Health: “Progetto Finalizzata Salute RF-2010-2312316, project title: Perioperative Optimization of Care in Obesity”. AH receives support from the British Heart Foundation (CS/13/1/30327, PG/13/6/29934, PG/15/75/31748, CS/15/6/31468, PG/17/90/33415, IG/18/5/33958), the National Institute for Health Research University College London Hospitals Biomedical Research Centre, and the UK Medical Research Council (MR/P023444/1) and works in a unit that receives support from the UK Medical Research Council (MC_UU_12019/1).
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/10
Y1 - 2020/10
N2 - Purpose Obesity clearly increases cardiovascular risk, often inducing high blood pressure (BP), impaired left ventricular (LV) function, and increased arterial stiffness. Intensive weight loss and bariatric surgery induce improvement in hypertension and diabetes for morbid obesity. Carotid artery haemodynamics is a powerful prognostic indicator for stroke and cognitive decline independent ofBP. The aim of this study was to evaluate the impact ofa 3-stage bariatric strategy of diet, bariatric surgery, and consequent weight loss on carotid haemodynamics and cardiac diastolic function. Material and Methods This prospective study included 26 patients (45 ± 10 years, 4 men) with severe obesity undergoing bariatric surgery without comorbidities (hypertension, diabetes, etc.). Anthropometry, BP, Doppler echocardiography, and common carotid haemodynamics by ultrasound were measured at three times: (1) baseline, (2) after 1-month diet (post-diet), and (3) 8 months after surgery (post-surgery). The lnDU-loop method was used to estimate local carotid pulse wave velocity (ncPWV). Results Baseline BMI was 47.9 ± 7.1 kg/m2 and reduced by 5% and 30% post-diet and post-surgery, respectively. BP decreased only post-diet, without pulse pressure change. However, ncPWV, 6.27 ± 1.35 m/s at baseline, was significantly reduced by 10% and 23% post-diet and post-surgery, respectively, also adjusted for BP changes. The E/A ratio rose from 0.95 ± 0.20 to 1.27 ± 0.31 (p < 0.005), without change in LV geometry or mass, while heart rate and cardiac output fell substantially.
AB - Purpose Obesity clearly increases cardiovascular risk, often inducing high blood pressure (BP), impaired left ventricular (LV) function, and increased arterial stiffness. Intensive weight loss and bariatric surgery induce improvement in hypertension and diabetes for morbid obesity. Carotid artery haemodynamics is a powerful prognostic indicator for stroke and cognitive decline independent ofBP. The aim of this study was to evaluate the impact ofa 3-stage bariatric strategy of diet, bariatric surgery, and consequent weight loss on carotid haemodynamics and cardiac diastolic function. Material and Methods This prospective study included 26 patients (45 ± 10 years, 4 men) with severe obesity undergoing bariatric surgery without comorbidities (hypertension, diabetes, etc.). Anthropometry, BP, Doppler echocardiography, and common carotid haemodynamics by ultrasound were measured at three times: (1) baseline, (2) after 1-month diet (post-diet), and (3) 8 months after surgery (post-surgery). The lnDU-loop method was used to estimate local carotid pulse wave velocity (ncPWV). Results Baseline BMI was 47.9 ± 7.1 kg/m2 and reduced by 5% and 30% post-diet and post-surgery, respectively. BP decreased only post-diet, without pulse pressure change. However, ncPWV, 6.27 ± 1.35 m/s at baseline, was significantly reduced by 10% and 23% post-diet and post-surgery, respectively, also adjusted for BP changes. The E/A ratio rose from 0.95 ± 0.20 to 1.27 ± 0.31 (p < 0.005), without change in LV geometry or mass, while heart rate and cardiac output fell substantially.
U2 - 10.1007/s11695-020-04686-y
DO - 10.1007/s11695-020-04686-y
M3 - Article
SN - 0960-8923
VL - 30
SP - 3776
EP - 3783
JO - Obesity Surgery
JF - Obesity Surgery
IS - 10
ER -