期刊
OBESITY SURGERY
卷 30, 期 10, 页码 3776-3783出版社
SPRINGER
DOI: 10.1007/s11695-020-04686-y
关键词
Bariatric surgery; Obesity; Carotid artery; LV function; Carotid local PWV; lnDU-loop
类别
资金
- Italian Ministry of Health [RF-2010-2312316]
- British Heart Foundation [CS/13/1/30327, PG/13/6/29934, PG/15/75/31748, CS/15/6/31468, PG/17/90/33415, IG/18/5/33958]
- National Institute for Health Research University College London Hospitals Biomedical Research Centre
- UK Medical Research Council [MC_UU_12019/1, MR/P023444/1]
- MRC [MC_UU_12019/1] Funding Source: UKRI
Purpose Obesity clearly increases cardiovascular risk, often inducing high blood pressure (BP), impaired left ventricular (LV) function, and increased arterial stiffness. Intensive weight loss and bariatric surgery induce improvement in hypertension and diabetes for morbid obesity. Carotid artery haemodynamics is a powerful prognostic indicator for stroke and cognitive decline independent of BP. The aim of this study was to evaluate the impact of a 3-stage bariatric strategy of diet, bariatric surgery, and consequent weight loss on carotid haemodynamics and cardiac diastolic function. Material and Methods This prospective study included 26 patients (45 +/- 10 years, 4 men) with severe obesity undergoing bariatric surgery without comorbidities (hypertension, diabetes, etc.). Anthropometry, BP, Doppler echocardiography, and common carotid haemodynamics by ultrasound were measured at three times: (1) baseline, (2) after 1-month diet (post-diet), and (3) 8 months after surgery (post-surgery). The lnDU-loop method was used to estimate local carotid pulse wave velocity (ncPWV). Results Baseline BMI was 47.9 +/- 7.1 kg/m(2) and reduced by 5% and 30% post-diet and post-surgery, respectively. BP decreased only post-diet, without pulse pressure change. However, ncPWV, 6.27 +/- 1.35 m/s at baseline, was significantly reduced by 10% and 23% post-diet and post-surgery, respectively, also adjusted for BP changes. The E/A ratio rose from 0.95 +/- 0.20 to 1.27 +/- 0.31 (p < 0.005), without change in LV geometry or mass, while heart rate and cardiac output fell substantially. Conclusion Weight loss following diet and bariatric surgery is associated with reduced carotid arterial stiffness and improved LV diastolic function. Diet and bariatric surgery are effective treatments for morbid obesity with its concomitant adverse cardiovascular effects.
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