title: Major weight loss prevents long-term left atrial enlargement in patients with morbid and extreme obesity.
abstract: OBJECTIVE
  To assess long-term changes in left atrial (LA) volume in patients with morbid obesity [body mass index (BMI) >or=35 kg/m(2) with co-morbidities] and extreme obesity (BMI >or=40 kg/m(2)), after surgically-induced weight loss (WL) after gastric bypass surgery.
  
  
  RESULTS
  We reviewed 57 patients who underwent gastric bypass surgery and had echocardiograms both before and after the operation. A control group was frequency-matched for BMI, sex, age, and for duration of follow-up. After a mean follow-up of 3.6 years, LA volume did not change significantly in patients who underwent bariatric surgery, but increased in the control group by 15 +/- 28 ml (P < 0.0001), and 0.1 +/- 0.2 ml (P < 0.0001) for height-indexed LA volume, with a difference between cases and controls that remained significant after adjusting for potential confounders (P = 0.01). In the study population as a whole, there was a positive correlation between change in body weight and change in LA volume (r = 0.22, P = 0.006) independent of clinical conditions associated with LA enlargement.
  
  
  CONCLUSIONS
  Change in body weight is associated with change in LA size independent of obesity-associated co-morbidities. Successful WL induced by bariatric surgery prevents the progressive increase in LA volume.
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, 200 First St SW, Rochester 55905, MN, USA.
authors.forename: Carolina A
authors.initials: CA
authors.lastname: Garza
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pellikka
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sarr
authors.forename: James B
authors.initials: JB
authors.lastname: Seward
authors.forename: Maria L
authors.initials: ML
authors.lastname: Collazo-Clavell
authors.forename: Elise
authors.initials: E
authors.lastname: Oehler
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
mesh_terms: D015992:Body Mass Index; D006332:Cardiomegaly / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control*; D016022:Case-Control Studies; D003971:Diastole; D005260:Female; D015390:Gastric Bypass; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D011446:Prospective Studies; D013997:Time Factors; D014463:Ultrasonography; D015431:Weight Loss