Key result
Roux-en-Y gastric bypass significantly improved the left ventricular ejection fraction to body surface area ratio from 26.2 to 29.2 (p=0.002) at 12 months in morbidly obese patients without cardiac history.
Why the study?
Morbid obesity causes higher cardiovascular morbidity and cardiac dysfunction, and it was unknown whether Roux-en-Y gastric bypass improves cardiac function.
Does Roux-en-Y gastric bypass improve cardiac function measured by CMRI in morbidly obese patients without a history of cardiac disease?
Cohort (n=13)
No
Does Roux-en-Y gastric bypass improve cardiac function measured by CMRI in morbidly obese patients without a history of cardiac disease?
Absolute Event Rate: 29.2% vs 26.2%
p-value: p=0.002
Roux-en-Y gastric bypass in morbidly obese patients without prior cardiac disease leads to significant improvements in BSA-corrected left ventricular ejection fraction and stroke volume at 12 months.
PURPOSE: Metabolic syndrome in patients with morbid obesity causes a higher cardiovascular morbidity, eventually leading to left ventricular hypertrophy and decreased left ventricular ejection fraction (LVEF). Roux-en-Y gastric bypass (RYGB) is considered the gold standard modality for treatment of morbid obesity and might even lead to improved cardiac function. Our objective is to investigate whether cardiac function in patients with morbid obesity improves after RYGB. MATERIALS AND METHODS: In this single center pilot study, 15 patients with an uneventful cardiac history who underwent RYGB were included from May 2015 to March 2016. Cardiac function was measured by cardiac magnetic resonance imaging (CMRI), performed preoperatively and 3, 6, and 12 months postoperative. LVEF and myocardial mass and cardiac output were measured. RESULTS: A total of 13 patients without decreased LVEF preoperative completed follow-up (mean age 37, 48.0 ± 8.8). There was a significant decrease of cardiac output 12 months postoperative (8.3 ± 1.8 preoperative vs. 6.8 ± 1.8 after 12 months, P = 0.001). Average myocardial mass declined by 15.2% (P < 0.001). After correction for body surface area (BSA), this appeared to be non-significant (P = 0.36). There was a significant improvement of LVEF/BSA at 6 and 12 months postoperative (26.2 ± 4.1 preoperative vs. 28.4 ± 3.4 and 29.2 ± 3.6 respectively, both P = 0.002). Additionally, there was a significant improvement of stroke volume/BSA 12 months after surgery (45.8 ± 8.0 vs. 51.9 ± 10.7, P = 0.033). CONCLUSION: RYGB in patients with morbid obesity with uneventful history of cardiac disease leads to improvement of cardiac function.
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Witte et al. (2020) conducted a cohort in Morbid obesity (n=13). Roux-en-Y gastric bypass vs. Preoperative baseline was evaluated on Left ventricular ejection fraction to body surface area ratio (LVEF/BSA) at 12 months (p=0.002). Roux-en-Y gastric bypass significantly improved the left ventricular ejection fraction to body surface area ratio from 26.2 to 29.2 (p=0.002) at 12 months in morbidly obese patients without cardiac history.
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