Progressive regression of left ventricular hypertrophy two years after bariatric surgery.
BACKGROUND
Obesity is a systemic disorder associated with an increase in left ventricular mass and premature death and disability from cardiovascular disease. Although bariatric surgery reverses many of the hormonal and hemodynamic derangements, the long-term collective effects on body composition and left ventricular mass have not been considered before. We hypothesized that the decrease in fat mass and lean mass after weight loss surgery is associated with a decrease in left ventricular mass.


METHODS
Fifteen severely obese women (mean body mass index [BMI]: 46.7+/-1.7 kg/m(2)) with medically controlled hypertension underwent bariatric surgery. Left ventricular mass and plasma markers of systemic metabolism, together with body mass index (BMI), waist and hip circumferences, body composition (fat mass and lean mass), and resting energy expenditure were measured at 0, 3, 9, 12, and 24 months.


RESULTS
Left ventricular mass continued to decrease linearly over the entire period of observation, while rates of weight loss, loss of lean mass, loss of fat mass, and resting energy expenditure all plateaued at 9 [corrected] months (P <.001 for all). Parameters of systemic metabolism normalized by 9 months, and showed no further change at 24 months after surgery.


CONCLUSIONS
Even though parameters of obesity, including BMI and body composition, plateau, the benefits of bariatric surgery on systemic metabolism and left ventricular mass are sustained. We propose that the progressive decrease of left ventricular mass after weight loss surgery is regulated by neurohumoral factors, and may contribute to improved long-term survival.
Algahim
Mohamed F
MF
Department of Internal Medicine, Division of Cardiology, University of Texas Medical School at Houston, University of Texas Health Science Center at Houston, Houston, TX 77030, USA.
Lux
Thomas R
TR
Leichman
Joshua G
JG
Boyer
Anthony F
AF
Miller
Charles C
CC
Laing
Susan T
ST
Wilson
Erik B
EB
Scarborough
Terry
T
Yu
Sherman
S
Snyder
Brad
B
Wolin-Riklin
Carol
C
Kyle
Ursula G
UG
Taegtmeyer
Heinrich
H
D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*