OBJECTIVES: 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.
OBJECTIVES: 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 obesepatients 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: Ted D Adams; Erick Avelar; Tom Cloward; Ross D Crosby; Robert J Farney; Richard Gress; R Chad Halverson; Paul N Hopkins; Ronette L Kolotkin; Michael J Lamonte; Sheldon Litwin; Robert T Nuttall; Robert Pendleton; Wayne Rosamond; Steven C Simper; Sherman C Smith; Michael Strong; James M Walker; Gail Wiebke; Frank G Yanowitz; Steven C Hunt Journal: Contemp Clin Trials Date: 2005-10 Impact factor: 2.226
Authors: M A Alpert; C R Lambert; H Panayiotou; B E Terry; M V Cohen; C V Massey; M W Hashimi; V Mukerji Journal: Am J Cardiol Date: 1995-12-01 Impact factor: 2.778
Authors: M A Alpert; C R Lambert; B E Terry; D L Kelly; H Panayiotou; V Mukerji; C V Massey; M V Cohen Journal: Am J Cardiol Date: 1994-05-01 Impact factor: 2.778
Authors: Thomas J Wang; Helen Parise; Daniel Levy; Ralph B D'Agostino; Philip A Wolf; Ramachandran S Vasan; Emelia J Benjamin Journal: JAMA Date: 2004-11-24 Impact factor: 56.272
Authors: Giovanni de Simone; Jorge R Kizer; Marcello Chinali; Mary J Roman; Jonathan N Bella; Lyle G Best; Elisa T Lee; Richard B Devereux Journal: Am J Hypertens Date: 2005-02 Impact factor: 2.689