title: Favorable changes in cardiac geometry and function following gastric bypass surgery: 2-year follow-up in the Utah obesity study.
abstract: OBJECTIVE
  The objective of this study was to test the hypothesis that gastric bypass surgery (GBS) would favorably impact cardiac remodeling and function.
  
  
  BACKGROUND
  GBS is increasingly used to treat severe obesity, but there are limited outcome data.
  
  
  METHODS
  We prospectively studied 423 severely obese patients undergoing GBS and a reference group of severely obese subjects that did not have surgery (n = 733).
  
  
  RESULTS
  At a 2-year follow up, GBS subjects had a large reduction in body mass index compared with the reference group (-15.4 ± 7.2 kg/m(2) vs. -0.03 ± 4.0 kg/m(2); p < 0.0001), as well as significant reductions in waist circumference, systolic blood pressure, heart rate, triglycerides, low-density lipoprotein cholesterol, and insulin resistance. High-density lipoprotein cholesterol increased. The GBS group had reductions in left ventricular (LV) mass index and right ventricular (RV) cavity area. Left atrial volume did not change in GBS but increased in reference subjects. In conjunction with reduced chamber sizes, GBS subjects also had increased LV midwall fractional shortening and RV fractional area change. In multivariable analysis, age, change in body mass index, severity of nocturnal hypoxemia, E/E', and sex were independently associated with LV mass index, whereas surgical status, change in waist circumference, and change in insulin resistance were not.
  
  
  CONCLUSIONS
  Marked weight loss in patients undergoing GBS was associated with reverse cardiac remodeling and improved LV and RV function. These data support the use of bariatric surgery to prevent cardiovascular complications in severe obesity.
authors.affiliation: Division of Cardiology, University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Theophilus
authors.initials: T
authors.lastname: Owan
authors.forename: Erick
authors.initials: E
authors.lastname: Avelar
authors.forename: Kimberly
authors.initials: K
authors.lastname: Morley
authors.forename: Ronny
authors.initials: R
authors.lastname: Jiji
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Hall
authors.forename: Joseph
authors.initials: J
authors.lastname: Krezowski
authors.forename: James
authors.initials: J
authors.lastname: Gallagher
authors.forename: Zachary
authors.initials: Z
authors.lastname: Williams
authors.forename: Kevin
authors.initials: K
authors.lastname: Preece
authors.forename: Nancy
authors.initials: N
authors.lastname: Gundersen
authors.forename: Michael B
authors.initials: MB
authors.lastname: Strong
authors.forename: Robert C
authors.initials: RC
authors.lastname: Pendleton
authors.forename: Nathan
authors.initials: N
authors.lastname: Segerson
authors.forename: Tom V
authors.initials: TV
authors.lastname: Cloward
authors.forename: James M
authors.initials: JM
authors.lastname: Walker
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Farney
authors.forename: Richard E
authors.initials: RE
authors.lastname: Gress
authors.forename: Ted D
authors.initials: TD
authors.lastname: Adams
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hunt
authors.forename: Sheldon E
authors.initials: SE
authors.lastname: Litwin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004452:Echocardiography; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006325:Heart Atria; D006352:Heart Ventricles; D006801:Humans; D008875:Middle Aged; D009200:Myocardial Contraction; D009765:Obesity / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D020257:Ventricular Remodeling