April 4, 2008Open Access
Major weight loss prevents long-term left atrial enlargement in patients with morbid and extreme obesity
Structured PICO
Does surgically-induced major weight loss prevent long-term left atrial enlargement in patients with morbid and extreme obesity?
P
Population
114 patients with morbid obesity (BMI ≥35 kg/m2 with co-morbidities) or extreme obesity (BMI ≥40 kg/m2), mean age 51.5 years, 39% male. Excluded: past medical history of cardiomyopathy secondary to a specific disease, pericardial disease, and severe valve disease.
I
Intervention
Roux-en-Y gastric bypass surgery for surgically-induced weight loss
C
Comparator
Frequency-matched control group (matched for sex, age, BMI, and follow-up duration) of patients with morbid or extreme obesity who did not undergo bariatric surgery
O
Outcome
Long-term changes in left atrial (LA) volume measured by biplane area-length method via echocardiography at mean 3.6 years follow-upsurrogate
Surgically-induced major weight loss prevents the progressive long-term increase in left atrial volume typically seen in morbidly obese patients, independent of other obesity-related comorbidities.
Abstract
AIMS: To assess long-term changes in left atrial (LA) volume in patients with morbid obesity body mass index (BMI) >or=35 kg/m(2) with co-morbidities and extreme obesity (BMI >or=40 kg/m(2)), after surgically-induced weight loss (WL) after gastric bypass surgery. METHODS AND RESULTS: We reviewed 57 patients who underwent gastric bypass surgery and had echocardiograms both before and after the operation. A control group was frequency-matched for BMI, sex, age, and for duration of follow-up. After a mean follow-up of 3.6 years, LA volume did not change significantly in patients who underwent bariatric surgery, but increased in the control group by 15 +/- 28 ml (P < 0.0001), and 0.1 +/- 0.2 ml (P < 0.0001) for height-indexed LA volume, with a difference between cases and controls that remained significant after adjusting for potential confounders (P = 0.01). In the study population as a whole, there was a positive correlation between change in body weight and change in LA volume (r = 0.22, P = 0.006) independent of clinical conditions associated with LA enlargement. CONCLUSION: Change in body weight is associated with change in LA size independent of obesity-associated co-morbidities. Successful WL induced by bariatric surgery prevents the progressive increase in LA volume.
Cite This Study
Garza et al. (Fri,) studied this question.