Major weight loss prevents long-term left atrial enlargement in patients with morbid and extreme obesity.
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.
Garza
Carolina A
CA
Division of Cardiovascular Diseases, Department of Medicine, 200 First St SW, Rochester 55905, MN, USA.
Pellikka
Patricia A
PA
Somers
Virend K
VK
Sarr
Michael G
MG
Seward
James B
JB
Collazo-Clavell
Maria L
ML
Oehler
Elise
E
Lopez-Jimenez
Francisco
F
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