Reversibility of cardiac abnormalities in morbidly obese adolescents.
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.
Ippisch
Holly M
HM
Division of Cardiology, Cincinnati Children's Hospital, Medical Center and Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45229, USA. Holly.Ippisch@cchmc.org
Inge
Thomas H
TH
Daniels
Stephen R
SR
Wang
Baiyang
B
Khoury
Philip R
PR
Witt
Sandra A
SA
Glascock
Betty J
BJ
Garcia
Victor F
VF
Kimball
Thomas R
TR
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