CV Improvements After Gastric Bypass Start Before Weight Loss Begins
The beneficial effects of bariatric surgery on the cardiovascular system are evident prior to significant weight loss and likely reflect changes in autonomic function along with improvements in circulating inflammation/oxidative stress, according to a new study.
“Indeed, at 1-week post-surgery we see better heart function and reduced central blood pressures,” said study author Paul D. Chantler, PhD, assistant professor of human performance–exercise physiology, West Virginia University.
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The researchers sought to evaluate the effect of weight reduction following laparoscopic Rouxen-Y gastric bypass (RYGB) on remodeling and improvements in arterial function, in addition to immediate reversal of metabolic deviations as weight is lost.
Patients who met protocol inclusion criteria joined the study during their 1-week preoperative clinical appointment. They lay supine for 10 minutes of quiet relaxation and then underwent a sequence of examinations, starting with a 12lead electrocardiogram, followed by an echocardiogram, carotid artery ultrasonography, radial artery applanation tonometry, and endothelial function analysis. Upon completion of the procedures, researchers took a fasting blood sample for analysis.
Preliminary findings show that RYGB results in significant body weight reduction in morbidly obese subjects, along with reductions in BMIand waist circumference at the 1week time point. Decrease in body size and weight was aided by a reduction in LDL, as well as suggested decreases in glucose levels.
Such changes can be associated with an improvement of the lipid and glucose metabolism, the researchers said. However, these results appear before subjects have lost a substantial amount of weight (1-week postoperative), suggesting that noteworthy cardiovascular improvements postRYGB are achieved prior to the hypothesized weightrelated change.
In addition, they saw a number of improvements to the cardiovascular system at the 1week time point. Estimated left ventricular end systolic pressure and direct measure of left ventricular end systolic volume declined postRYGB, with an array of additional markers supporting alterations in central systolic blood pressure and myocardial oxygen demand.
“The data suggest that vascular changes are happening in the early stages of recovery, prior to dramatic weight loss, thus suggesting vascular modifications are a result of an alternate surgical benefit,” they concluded.
It remains important to have a balanced lifestyle of exercise and good dietary habits, but this study highlights that a minimally invasive surgery can provide important effects on the cardiovascular system, Chantler said. “Previous evidence has shown that bariatric surgery can significantly improve insulin sensitivity and diabetic conditions. Further, patients comment on how they’re no longer on cardiovascular medications months after this surgery.”
For future research, he wishes to track results longitudinally and further explore the reasons behind the beneficial changes seen after bariatric surgery.
—Mike Bederka
Reference:
Grogg K, DeVallance E, Lemaster K, et al. Early improvements in blood lipid profile and vascular alterations after gastric bypass surgery prior to dramatic weight loss. Presented at Experimental Biology 2016; April 6, 2016; San Diego, CA.