title: Maladaptive enlargement of the brachial artery in severe obesity is reversed with weight loss.
abstract: Maladaptive peripheral arterial remodeling, which leads to large arteries with low shear stress, may be associated with increased cardiovascular risk. We tested the hypothesis that arterial enlargement in severe obesity represents maladaptive remodeling and that weight reduction would reverse this process. We evaluated brachial arterial diameter and flow using ultrasound in 244 severely obese patients (age 44 +/- 11 years, 80% female, body mass index (BMI) 46 +/- 9 kg/m) at baseline and in a group of 67 subjects who experienced weight loss at 1 year. Higher BMI was associated with larger brachial artery diameter (p = 0.01) and lower shear stress (p = 0.008), indicating maladaptive remodeling. Significant (> or = 10%) weight reduction was associated with a decrease in resting arterial diameter (-0.19 +/- 0.47 mm, p = 0.02) along with a trend toward increased shear stress. Decreased systemic inflammation was associated with weight loss-induced reverse remodeling of the brachial artery. Our findings demonstrate the presence of maladaptive arterial remodeling in advanced obesity that was ameliorated by significant weight loss.
authors.affiliation: Evans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA. Naomi.hamburg@bmc.org
authors.forename: Naomi M
authors.initials: NM
authors.lastname: Hamburg
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Mott
authors.forename: Sherman J
authors.initials: SJ
authors.lastname: Bigornia
authors.forename: Mai-Ann
authors.initials: MA
authors.lastname: Duess
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Kluge
authors.forename: Donald T
authors.initials: DT
authors.lastname: Hess
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Apovian
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Vita
authors.forename: Noyan
authors.initials: N
authors.lastname: Gokce
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013314:Stress, Mechanical; D014463:Ultrasonography; D015431:Weight Loss / Q000502:physiology*