title: Reversibility of cardiac abnormalities in morbidly obese adolescents.
abstract: OBJECTIVE
  The purpose of this study was to evaluate changes in cardiac geometry, systolic and diastolic function before and after weight loss in morbidly obese adolescents.
  
  
  BACKGROUND
  Cardiac abnormalities are present in morbidly obese adolescents; however, it is unclear if they are reversible with weight loss.
  
  
  METHODS
  Data from 38 adolescents (13 to 19 years; 29 females, 9 males, 33 Caucasians, 5 African Americans) were evaluated before and after bariatric surgery. Left ventricular mass (LVM), left ventricular (LV) geometry, systolic and diastolic function were assessed by echocardiography. Mean follow up was 10 +/- 3 months.
  
  
  RESULTS
  Weight and body mass index decreased post-operatively (mean weight loss 59 +/- 15 kg, pre-operative body mass index 60 +/- 9 kg/m(2) vs. follow-up 40 +/- 8 kg/m(2), p < 0.0001). Change in LVM index (54 +/- 13 g/m(2.7) to 42 +/- 10 g/m(2.7), p < 0.0001) correlated with weight loss (r = 0.41, p = 0.01). Prevalence of concentric left ventricular hypertrophy (LVH) improved from 28% at pre-operative to only 3% at follow up (p = 0.007), and normal LV geometry improved from 36% to 79% at follow up (p = 0.009). Diastolic function also improved (mitral E/Ea lateral 7.7 +/- 2.3 at pre-operative vs. 6.3 +/- 1.6 at post-operative, p = 0.003). In addition, rate-pressure product improved suggesting decreased cardiac workload (p < 0.001).
  
  
  CONCLUSIONS
  Elevated LVM index, concentric LVH, altered diastolic function, and cardiac workload significantly improve following surgically induced weight loss in morbidly obese adolescents. Large weight loss due to bariatric surgery improves predictors of future cardiovascular morbidity in these young people.
authors.affiliation: Division of Cardiology, Cincinnati Children's Hospital, Medical Center and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45229, USA. Holly.Ippisch@cchmc.org
authors.forename: Holly M
authors.initials: HM
authors.lastname: Ippisch
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Inge
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.forename: Baiyang
authors.initials: B
authors.lastname: Wang
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Witt
authors.forename: Betty J
authors.initials: BJ
authors.lastname: Glascock
authors.forename: Victor F
authors.initials: VF
authors.lastname: Garcia
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kimball
mesh_terms: D000293:Adolescent; D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D003971:Diastole; D018450:Disease Progression; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D015995:Prevalence; D013599:Systole; D015431:Weight Loss