title: Improvement in cardiovascular indices after Roux-en-Y gastric bypass or sleeve gastrectomy for morbid obesity.
abstract: BACKGROUND
  Morbidly obese patients display cardiac abnormalities which are partially reversed after weight loss. The aim of the present study was to assess the potential difference in cardiovascular disease indices between patients who underwent either gastric bypass surgery or sleeve gastrectomy.
  
  
  METHODS
  Thirty-seven morbidly obese patients who underwent either Roux-en-Y gastric bypass (RYGB) (n = 14) or SG (n = 23) were examined before, 3 and 6 months after surgery. Indices of cardiac autonomic nervous system activity were evaluated, namely baroreflex sensitivity (BRS) and heart rate variability (HRV). A complete echocardiographic study was performed in a subgroup of 17 patients (RYGB 8, SG 9) preoperatively and 6 months after surgery, evaluating epicardial fat thickness, aortic distensibility, left ventricular (LV) Tei index, left atrium diameter, ejection fraction, and LV mass.
  
  
  RESULTS
  All subjects experienced significant (p < 0.001) and similar weight loss independently of the type of operation. BRS and HRV indices improved significantly and to the same degree after surgery in both groups. In the echocardiographic study, all parameters improved significantly at 6 months in comparison with the baseline values. In addition, the RYGB group displayed significantly greater reduction in epicardial fat thickness (p = 0.007) and also tended to have a better LV performance as expressed by the lower values of the Tei index (p = 0.06) compared to the SG group 6 months after surgery.
  
  
  CONCLUSIONS
  Both RYGB and SG exert comparable effects on weight loss and improvement of cardiovascular parameters. RYGB displays a more beneficial influence on epicardial fat thickness and left ventricular performance than SG.
authors.affiliation: First Department of Propaedeutic Medicine, Laiko General Hospital, Athens University Medical School, 17 Agiou Thoma Street, 11527 Athens, Greece.
authors.forename: Alexander
authors.initials: A
authors.lastname: Kokkinos
authors.forename: Kleopatra
authors.initials: K
authors.lastname: Alexiadou
authors.forename: Christos
authors.initials: C
authors.lastname: Liaskos
authors.forename: Georgia
authors.initials: G
authors.lastname: Argyrakopoulou
authors.forename: Ioanna
authors.initials: I
authors.lastname: Balla
authors.forename: Nicholas
authors.initials: N
authors.lastname: Tentolouris
authors.forename: Ioannis
authors.initials: I
authors.lastname: Moyssakis
authors.forename: Nicholas
authors.initials: N
authors.lastname: Katsilambros
authors.forename: Irene
authors.initials: I
authors.lastname: Vafiadis
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.forename: Theodoros
authors.initials: T
authors.lastname: Diamantis
mesh_terms: D000328:Adult; D017704:Baroreflex; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D011446:Prospective Studies; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D015431:Weight Loss