TY - JOUR
T1 - Structural and Functional Changes in Left and Right Ventricles After Major Weight Loss Following Bariatric Surgery for Morbid Obesity
AU - Garza, Carolina A.
AU - Pellikka, Patricia A.
AU - Somers, Virend K.
AU - Sarr, Michael G.
AU - Collazo-Clavell, Maria L.
AU - Korenfeld, Yoel
AU - Lopez-Jimenez, Francisco
N1 - Funding Information:
Dr. Lopez-Jimenez is a recipient of a Clinical Scientist Development Award from the American Heart Association, Dallas, Texas, and Dr. Somers is supported by grants HL-65,176 , HL-70,302 , HL-73,211 , and M01-RR00 585 from the National Institutes of Health , Bethesda, Maryland.
PY - 2010/2/15
Y1 - 2010/2/15
N2 - Obesity and bariatric surgery have been associated with changes in ventricular function and structure. The aim of the present study was to assess the long-term changes in left ventricular (LV) and right ventricular (RV) function and structure in patients with morbid obesity-body mass index ≥40 kg/m2 or ≥35 kg/m2 with co-morbidities-who had lost weight after bariatric surgery compared to nonsurgical controls. We reviewed 57 patients with morbid obesity who had undergone gastric bypass surgery and who had undergone echocardiography before and after surgery. A reference group (n = 57) was frequency matched for body mass index (±2 kg/m2), gender, age (±2 years), and follow-up duration (±6 months). After a mean follow-up of 3.6 years, the LV mass and LV mass indexed by height had decreased in the patients who had undergone bariatric surgery and had lost weight. In contrast, these measurements had increased in the patients who had not undergone bariatric surgery. The difference between these 2 groups remained significant after adjusting for potential confounders. At follow-up, neither the patients nor controls showed a significant change in ejection fraction, LV myocardial performance index, or RV myocardial performance index. In the study population as a whole, multivariate analysis showed a positive correlation between the change in body weight and ventricular septum thickness (R = 0.33), posterior wall thickness (R = 0.31), LV mass (R = 0.38), RV end-diastolic area (R = 0.22), and estimated RV systolic pressure (R = 0.39), all with p values <0.05. In conclusion, body weight changes in patients with morbid obesity were associated with changes in LV structure independent of improvement in obesity-related co-morbidities, including obstructive sleep apnea. Weight loss improved the RV end-diastolic area and might prevent progression to RV dysfunction.
AB - Obesity and bariatric surgery have been associated with changes in ventricular function and structure. The aim of the present study was to assess the long-term changes in left ventricular (LV) and right ventricular (RV) function and structure in patients with morbid obesity-body mass index ≥40 kg/m2 or ≥35 kg/m2 with co-morbidities-who had lost weight after bariatric surgery compared to nonsurgical controls. We reviewed 57 patients with morbid obesity who had undergone gastric bypass surgery and who had undergone echocardiography before and after surgery. A reference group (n = 57) was frequency matched for body mass index (±2 kg/m2), gender, age (±2 years), and follow-up duration (±6 months). After a mean follow-up of 3.6 years, the LV mass and LV mass indexed by height had decreased in the patients who had undergone bariatric surgery and had lost weight. In contrast, these measurements had increased in the patients who had not undergone bariatric surgery. The difference between these 2 groups remained significant after adjusting for potential confounders. At follow-up, neither the patients nor controls showed a significant change in ejection fraction, LV myocardial performance index, or RV myocardial performance index. In the study population as a whole, multivariate analysis showed a positive correlation between the change in body weight and ventricular septum thickness (R = 0.33), posterior wall thickness (R = 0.31), LV mass (R = 0.38), RV end-diastolic area (R = 0.22), and estimated RV systolic pressure (R = 0.39), all with p values <0.05. In conclusion, body weight changes in patients with morbid obesity were associated with changes in LV structure independent of improvement in obesity-related co-morbidities, including obstructive sleep apnea. Weight loss improved the RV end-diastolic area and might prevent progression to RV dysfunction.
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U2 - 10.1016/j.amjcard.2009.09.057
DO - 10.1016/j.amjcard.2009.09.057
M3 - Article
C2 - 20152253
AN - SCOPUS:75349092716
SN - 0002-9149
VL - 105
SP - 550
EP - 556
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 4
ER -