title: Impact of bariatric surgery on N-terminal fragment of the prohormone brain natriuretic peptide and left ventricular diastolic function.
abstract: BACKGROUND
  Obesity is often associated with left ventricular (LV) diastolic dysfunction (DD). Elevated N-terminal fragment of the prohormone brain natriuretic peptide (NT-proBNP) is considered a biomarker of LV dysfunction. Weight loss induced by bariatric surgery may improve LV DD, but conflicting results regarding NT-proBNP levels have been reported. Our objective was to determine the impact of bariatric surgery-induced weight loss on NT-proBNP levels and LV DD.
  
  
  METHODS
  Seventy (70) patients were evaluated before and 6 and 12 months following a biliopancreatic diversion with duodenal switch (BPD-DS), and 33 subjects were followed as controls at baseline and 6 and 12 months later. Blood was collected for NT-proBNP measurement, and LV diastolic function was assessed with echocardiography.
  
  
  RESULTS
  Among the 103 severely obese patients, 82% presented some degree of LV DD. Systolic function was preserved in all subjects. Along with significant weight loss, LV DD significantly improved (P < 0.001) in the BPD-DS group, whereas there was no change in the control group. NT-proBNP levels decreased over time in the control group (P = 0.016) and increased in subjects following BPD-DS (baseline vs 6-month vs 12-month follow-up: 51.8 ± 62.8 vs 132.0 ± 112.9 vs 143.3 ± 120.4 pg/mL; P < 0.001). The most significant associations with changes in NT-proBNP levels were improvements in the metabolic profile.
  
  
  CONCLUSIONS
  In severely obese patients, NT-proBNP levels decrease with sustained obesity for 1 year. Despite significant improvements in LV DD following bariatric surgery, NT-proBNP levels increase. These results suggest that monitoring NT-proBNP levels following bariatric surgery may be misleading regarding LV DD and symptoms of dyspnea.
authors: Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Québec, Canada.
authors: Julie
authors: J
authors: Martin
authors: Sébastien
authors: S
authors: Bergeron
authors: Philippe
authors: P
authors: Pibarot
authors: Marjorie
authors: M
authors: Bastien
authors: Laurent
authors: L
authors: Biertho
authors: Odette
authors: O
authors: Lescelleur
authors: Fernand
authors: F
authors: Bertrand
authors: Serge
authors: S
authors: Simard
authors: Paul
authors: P
authors: Poirier
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015415:Biomarkers / Q000097:blood*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D010446:Peptide Fragments / Q000097:blood*; D012307:Risk Factors; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging; D016277:Ventricular Function, Left; D015431:Weight Loss
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain