Improvements in systemic metabolism, anthropometrics, and left ventricular geometry 3 months after bariatric surgery.
BACKGROUND
Several lines of evidence have suggested a link between obesity and heart failure, including chronic inflammation, increased sympathetic tone, and insulin resistance. The goal of this study was to evaluate the changes in systemic metabolism, anthropometrics, and left ventricular (LV) contraction, as well as geometry, in clinically severe obese women after bariatric surgery.


METHODS
Enrollment was offered consecutively to 22 women with clinically severe obesity. Participants underwent abdominal magnetic resonance imaging to quantify the visceral adipose tissue (VAT) area and tissue Doppler imaging echocardiography to measure the LV contractile function. Fasting blood chemistries were drawn to measure inflammatory markers and to calculate insulin sensitivity. All tests were performed before surgery and 3 months postoperatively.


RESULTS
Three months after surgery, a significant increase in insulin sensitivity (mean change +/- SEM 34.0 +/- 10.4, P < .0001) was present. The VAT area had significantly decreased (-66.1 +/- 17.8 cm2, P = .002) and was associated with decreases in body mass index, serum glucose concentrations, and high-sensitivity C-reactive protein levels (r = .61 and P = .005, r = .48 and P = .033, and r = .53 and P = .016, respectively). The LV mass decreased significantly (-3.8 +/- 1.7 g/m(2.7), P = .037), and this decrease was associated with a decrease in glucose concentration (r = .46, P = .041). The LV systolic and diastolic contractile function were normal at baseline, and no change occurred after surgery.


CONCLUSIONS
The early phase of weight loss after bariatric surgery produces favorable changes in LV geometry, and these are associated with normalization in the glucose metabolism.
Leichman
Joshua G
JG
Division of Cardiology, University of Texas Houston Medical School, Houston, Texas 77030, USA.
Aguilar
David
D
King
Terri M
TM
Mehta
Snehal
S
Majka
Charles
C
Scarborough
Terry
T
Wilson
Erik B
EB
Taegtmeyer
Heinrich
H
D000328:Adult; D000704:Analysis of Variance; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
D001786:Blood Glucose; D002097:C-Reactive Protein