title: Improvement in coronary circulatory function in morbidly obese individuals after gastric bypass-induced weight loss: relation to alterations in endocannabinoids and adipocytokines.
abstract: OBJECTIVE
  To investigate the effect of surgical gastric bypass-induced weight loss and related alterations in endocannabinoids (ECs) and adipocytokine plasma levels on coronary circulatory dysfunction in morbidly obese (MOB) individuals.
  
  
  RESULTS
  Myocardial blood flow (MBF) responses to cold pressor test (CPT) from rest (ΔMBF) and during pharmacologically induced hyperaemia were measured with ¹³N-ammonia PET/CT in 18 MOB individuals with a body mass index (BMI) > 40 kg/m² at baseline and after a median follow-up period of 22 months. Gastric bypass intervention decreased BMI from a median of 44.8 (inter-quartile range: 43.3, 48.2) to 30.8 (27.3, 34.7) kg/m² (P < 0.0001). This decrease in BMI was accompanied by a marked improvement in endothelium-related ΔMBF to CPT and hyperaemic MBFs, respectively [0.34 (0.18, 0.41) from 0.03 (-0.08, 0.15) mL/g/min, P = 0.002; and 2.51 (2.17, 2.64) from 1.53 (1.39, 2.18) mL/g/min, P < 0.001]. There was an inverse correlation between decreases in plasma concentrations of the EC anandamide and improvement in ΔMBF to CPT (r = -0.59, P = 0.009), while increases in adiponectin plasma levels correlated positively with hyperaemic MBFs (r = 0.60, P = 0.050). Conversely, decreases in leptin plasma concentrations were not observed to correlate with the improvement in coronary circulatory function (r = 0.22, P = 0.400, and r = -0.31, P = 0.250).
  
  
  CONCLUSIONS
  Gastric bypass-related reduction of BMI in MOB individuals beneficially affects coronary circulatory dysfunction. The dysbalance between ECs and adipocytokines appears to be an important determinant of coronary circulatory function in obesity.
authors.affiliation: Division of Cardiology, Department of Specialties in Medicine, 6th Floor, Nuclear Cardiology, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1211 Geneva, Switzerland.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Quercioli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Pataky
authors.forename: Aurelien
authors.initials: A
authors.lastname: Thomas
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ambrosio
authors.forename: Christian
authors.initials: C
authors.lastname: Staub
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Marzo
authors.forename: Osman
authors.initials: O
authors.lastname: Ratib
authors.forename: Francois
authors.initials: F
authors.lastname: Mach
authors.forename: Alain
authors.initials: A
authors.lastname: Golay
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Schindler
mesh_terms: D054392:Adipokines / Q000378:metabolism*; D000273:Adipose Tissue / Q000378:metabolism; D000328:Adult; D003326:Coronary Circulation / Q000502:physiology*; D063388:Endocannabinoids / Q000378:metabolism*; D005260:Female; D015390:Gastric Bypass; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000601:surgery; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D013312:Stress, Physiological; D014057:Tomography, X-Ray Computed; D014666:Vasomotor System / Q000502:physiology; D015431:Weight Loss / Q000502:physiology
chemical_list: D054392:Adipokines; D063388:Endocannabinoids
keywords: Adipocytokines; Coronary circulation; Endocannabinoids; Endothelium; Myocardial blood flow; Obesity; Positron emission tomography