Gastric bypass surgery in severely obese patients was associated with a significant reduction in body mass index (-15.4 vs. -0.03 kg/m2; p<0.0001) and reverse cardiac remodeling.
Cohort (n=1,156)
Does gastric bypass surgery improve cardiac remodeling and function in severely obese patients?
Gastric bypass surgery in severely obese patients is associated with significant weight loss, reverse cardiac remodeling, and improved biventricular function at 2 years compared to non-surgical controls.
Absolute Event Rate: -15.4% vs -0.03%
p-value: p=<0.0001
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/m2 vs. −0.03 ± 4.0 kg/m2; 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.
Owan et al. (Tue,) conducted a cohort in Severe obesity (n=1,156). Gastric bypass surgery vs. No surgery was evaluated on Change in body mass index (p=<0.0001). Gastric bypass surgery in severely obese patients was associated with a significant reduction in body mass index (-15.4 vs. -0.03 kg/m2; p<0.0001) and reverse cardiac remodeling.