title: Long-term effects of bariatric surgery on peripheral endothelial function and coronary microvascular function.
abstract: We previously demonstrated that bariatric surgery (BS) leads to a short-term significant improvement of endothelial function and coronary microvascular function. In this study we assessed whether BS maintains its beneficial effect at long-term follow up.
  
  
  
  We studied 19 morbidly obese patients (age 43±9years, 12 women) without any evidence of cardiovascular disease who underwent BS. Patients were studied before BS, at 3 months and at 4.0±1.5years follow up.
  
  
  
  Peripheral vascular function was assessed by flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD), i.e., brachial artery diameter changes in response to post-ischemic forearm hyperhaemia and to nitroglycerin administration, respectively. Coronary microvascular function was assessed by measuring coronary blood flow (CBF) response to intravenous adenosine and to cold pressor test (CPT) in the left anterior descending coronary artery.
  
  
  
  Together with improvement of anthropometric and metabolic profile, at long-term follow-up patients showed a significant improvement of FMD (6.43±2.88 vs. 8.21±1.73%, p=0.018), and CBF response to both adenosine (1.73±0.48 vs. 2.58±0.54; p<0.01) and CPT (1.43±0.30 vs. 2.23±0.48; p<0.01), compared to basal values. No differences in vascular end-points were shown at 3-month and 4-year follow-up after BS.
  
  
  
  Our data show that, in morbidly obese patients, BS exerts beneficial and long lasting effects on peripheral endothelial function and on coronary microvascular dilator function.
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Tarzia
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy. Electronic address: gaetanoantonio.lanza@unicatt.it.
authors.forename: Gaetano A
authors.initials: GA
authors.lastname: Lanza
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Sestito
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Villano
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Russo
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Figliozzi
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Lamendola
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: De Vita
authors.affiliation: Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001916:Brachial Artery; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control; D003331:Coronary Vessels / Q000502:physiology / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000502:physiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D055806:Microvessels / Q000502:physiology / Q000503:physiopathology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D055815:Young Adult
keywords: Bariatric surgery; Coronary microvascular function; Endothelial function; Obesity