Cardiovascular benefits of bariatric surgery

Lee, Glenn K.; Mei, Yong

doi:10.1016/j.tcm.2015.07.006

Cited by 33 publications

(15 citation statements)

References 82 publications

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“…In the American College of Surgeons Bariatric Surgery Network database, mortality 30 days after sleeve gastrectomy was 0.11% and Roux-en-Y gastric bypass 0.14%. The 30-day morbidity rate was 5.6% for sleeve gastrectomy and 5.9% for Roux-en-Y gastric bypass [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Bariatric surgery and cardiovascular outcome

et al. 2020

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Background Obesity is recognized as a classic risk factor for atherosclerosis and subsequent cardiovascular disease (CVD). Weight loss after bariatric surgery has been associated with reduced CV mortality and total mortality in obese patients. Our aim was to study the impact of bariatric surgery on CV risk profile, cardiac structure, and function postoperatively. Results This prospective longitudinal study included 100 morbidly obese patients at final analysis. All patients were subjected to full clinical, laboratory, and echocardiographic examination at baseline and 6 months after bariatric surgery. The mean age of study population was 37.2 ± 10.49 with BMI of 47 ± 6.82. Females represented 84%. Sleeve gastrectomy and Roux-en-Y gastric bypass were performed in 79% and 21%, respectively. Surgery-related mortality and morbidity were 0.94% and 4.7%, respectively. After 6 months, there were significant decreases in BMI, heart rate, SBP, DBP, and Framingham risk score (P < 0.0001). The prevalence of risk factors decreased as follows: hypertension 24% vs. 12%, P = 0.0005; DM 21% vs. 11%, P = 0.002; dyslipidemia 32% vs. 7%, P < 0.0001; and metabolic syndrome 54% vs. 26%, P < 0.0001. Highly significant (P < 0.0001) decrease in fasting PG and 2 h PP-PG, HbA1c, ASL, ALT, fasting total cholesterol, LDL, TG, and increase in HDL were observed after bariatric surgery. There were significant shortening in QTc interval (P = 0.009), decrease in LV dimensions and LV mass index (P < 0.0001), and increase in LV EF% (P = 0.0003). BMI at follow-up showed significant positive correlation with age, Framingham risk score, and preoperative BMI (r = 0.289, P = 0.0036; r = 0.37, P = 0.0054; and r = 0.31, P = 0.0081, respectively). Conclusion In addition to enabling patients to achieve a substantial weight loss, bariatric surgery provides a myriad of health benefits. Weight reduction was associated with a favorable improvement in cardiovascular risk profile, cardiac structure, and function.

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Section: Discussionmentioning

confidence: 99%

Bariatric surgery and cardiovascular outcome

et al. 2020

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“…Laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) are currently the most common performed procedures worldwide, although more recently the One Anastomosis/Mini-Gastric Bypass (OAGB/ MGB) has gained popularity (1) . Bariatric surgery results in rapid weight loss and reduction of obesity-related co-morbidities such as hypertension, hypercholesterolaemia, diabetes mellitus type 2 and obstructive sleep apnoea syndrome (2) . In spite of multiple clinical benefits, bariatric surgery can lead to deficiencies in macronutrients and micronutrients as a consequence of reduced intake, changes in eating pattern, food intolerance, gastrointestinal symptoms and malabsorption (3,4) .…”

Section: Introductionmentioning

confidence: 99%

Patient adherence to multivitamin supplementation after bariatric surgery: a narrative review

et al. 2020

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Morbid obesity is a growing problem worldwide and has subsequently resulted in a wide application of bariatric surgery to achieve long-term weight loss and improvement of obesity-related co-morbidities. In spite of these clinical benefits, vitamin deficiencies are common after bariatric surgery; therefore, lifelong multivitamin supplementation (MVS) is recommended. However, patient adherence to MVS intake is generally poor. The aim of this narrative review is to analyse which factors influence the adherence of MVS intake after bariatric surgery. To provide an extensive overview, we will discuss the different factors that influence MVS use in patients who underwent bariatric surgery, but also review the literature on MVS in other patient groups.

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“…Obesity has direct effects on CV structure by increasing myocardial fat deposition and altering hemodynamic function ( 2 ). In addition, obesity triggers an increased sympathetic activity and a decreased systemic vascular resistance, which result in increased heart rate and cardiac output, generating cardiac overload and eventually leading to left ventricular hypertrophy, atria dilation ( 3 ), heart dysfunction and dysrhythmia ( 4 ). Moreover, obesity is the central feature of the metabolic syndrome, which includes other CV risk factors such as high blood pressure (BP), lipid abnormalities and altered glucose homeostasis or type 2 diabetes (T2D) ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Diabetic and Elder Patients Experience Superior Cardiovascular Benefits After Gastric Bypass Induced Weight Loss

et al. 2018

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Background/Objetives: Obesity and obesity related co-morbidities are well-recognized risks for cardiovascular (CV) disease and mortality. Weight loss improves CV risk factors and the efficacy of bariatric surgery in decreasing CV mortality is now well-established. Our aim was to assess CV risk progression and occurrence of CV events in a cohort of patients that underwent Roux-en-Y gastric bypass (RYGB) for obesity treatment in a single academic public center.Subjects and Methods: Ten year CV risk was estimated using the Framingham Equation at baseline and 2 years after RYGB surgery in our patients cohort (n = 260). In the subgroup with a follow-up time longer than 4 years after surgery (n = 185; mean 5.4 ± 0.1 years), CV risk adjusted for the time length after RYGB was similarly estimated and the occurrence of CV events for outcome adjudication was monitored during the same time period by reviewing the hospital patients' record, the electronic national health system patient register and our center outpatient clinic records.Results: Ten year CV risk was significantly reduced 2 years after surgery when compared to baseline, with reductions of 1.65 ± 0.25% in the risk of CV disease. Patients with prior type 2 diabetes and aged 50 years or older experienced a significantly superior CV risk reduction, with diabetic patients experiencing a reduction of their 10–year CV disease risk of 3.58 ± 1.11% vs. a reduction of 1.31 ± 0.20% in non-diabetic patients and with the 10–year risk of CV disease dropping 3.41 ± 0.75% in patients older than 50 vs. a reduction of 0.99 ± 0.18 in patients up to 50 years. For the subgroup of patients with a longer follow-up time, baseline CV risk estimation predicted the occurrence of 6.08 ± 0.56 cardiovascular disease (CVD) events, 3.87 ± 0.39 coronary heart disease (CHD) events, 1.49 ± 0.22 myocardial infarctions (MI), 0.71 ± 0.09 strokes, 0. 28 ± 0.05 deaths from CHD and 0.35 ± 0.05 deaths from CVD. No CV events were adjudicated in this subgroup during follow-up.Conclusions: RYGB significantly improves CV risk and prevents the occurrence of CV events. For similar weight loss, diabetic and elder patients experience a superior CV risk improvement and may have additional CV benefits after bariatric surgery.

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Cardiovascular benefits of bariatric surgery

Cited by 33 publications

References 82 publications

Bariatric surgery and cardiovascular outcome

Bariatric surgery and cardiovascular outcome

Patient adherence to multivitamin supplementation after bariatric surgery: a narrative review

Diabetic and Elder Patients Experience Superior Cardiovascular Benefits After Gastric Bypass Induced Weight Loss

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