The effect of bariatric surgery type on cardiac reverse remodelling
Introduction: Bariatric surgery is effective in reversing adverse cardiac remodelling in obesity. However, it is unclear whether the three commonly performed operations; Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Adjustable Gastric Band (LAGB) are equal i...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Springer Nature [academic journals on nature.com]
2024
|
| _version_ | 1811140165708546048 |
|---|---|
| author | Henry, JA Abdesselam, I Deal, O Lewis, AJ Rayner, J Bernard, M Dutour, A Gaborit, B Kober, F Soghomonian, A Sgromo, B Byrne, J Bege, T Borlaug, BA Neubauer, S Rider, OJ |
| author_facet | Henry, JA Abdesselam, I Deal, O Lewis, AJ Rayner, J Bernard, M Dutour, A Gaborit, B Kober, F Soghomonian, A Sgromo, B Byrne, J Bege, T Borlaug, BA Neubauer, S Rider, OJ |
| author_sort | Henry, JA |
| collection | OXFORD |
| description | Introduction: Bariatric surgery is effective in reversing adverse cardiac remodelling in obesity. However, it is unclear whether the three commonly performed operations; Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Adjustable Gastric Band (LAGB) are equal in their ability to reverse remodelling. Methods: Fifty-eight patients underwent CMR to assess left ventricular mass (LVM), LV mass:volume ratio (LVMVR) and LV eccentricity index (LVei) before and after bariatric surgery (26 RYGB, 22 LSG and 10 LAGB), including 46 with short-term (median 251–273 days) and 43 with longer-term (median 983–1027 days) follow-up. Abdominal visceral adipose tissue (VAT) and epicardial adipose tissue (EAT) were also assessed. Results: All three procedures resulted in significant decreases in excess body weight (48–70%). Percentage change in VAT and EAT was significantly greater following RYGB and LSG compared to LAGB at both timepoints (VAT:RYGB −47% and −57%, LSG −47% and −54%, LAGB −31% and −25%; EAT:RYGB −13% and −14%, LSG –16% and −19%, LAGB −5% and −5%). Patients undergoing LAGB, whilst having reduced LVM (−1% and −4%), had a smaller decrease at both short (RYGB: −8%, p < 0.005; LSG: −11%, p < 0.0001) and long (RYGB: −12%, p = 0.009; LSG: −13%, p < 0.0001) term timepoints. There was a significant decrease in LVMVR at the long-term timepoint following both RYGB (−7%, p = 0.006) and LSG (−7%, p = 0.021), but not LAGB (−2%, p = 0.912). LVei appeared to decrease at the long-term timepoint in those undergoing RYGB (−3%, p = 0.063) and LSG (−4%, p = 0.015), but not in those undergoing LAGB (1%, p = 0.857). In all patients, the change in LVM correlated with change in VAT (r = 0.338, p = 0.0134), while the change in LVei correlated with change in EAT (r = 0.437, p = 0.001). Conclusions: RYGB and LSG appear to result in greater decreases in visceral adiposity, and greater reverse LV remodelling with larger reductions in LVM, concentric remodelling and pericardial restraint than LAGB. |
| first_indexed | 2024-09-25T04:17:39Z |
| format | Journal article |
| id | oxford-uuid:b3b34710-225a-42a2-b278-21c839d7c32a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-09-25T04:17:39Z |
| publishDate | 2024 |
| publisher | Springer Nature [academic journals on nature.com] |
| record_format | dspace |
| spelling | oxford-uuid:b3b34710-225a-42a2-b278-21c839d7c32a2024-07-20T16:16:01ZThe effect of bariatric surgery type on cardiac reverse remodellingJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:b3b34710-225a-42a2-b278-21c839d7c32aEnglishJisc Publications RouterSpringer Nature [academic journals on nature.com]2024Henry, JAAbdesselam, IDeal, OLewis, AJRayner, JBernard, MDutour, AGaborit, BKober, FSoghomonian, ASgromo, BByrne, JBege, TBorlaug, BANeubauer, SRider, OJIntroduction: Bariatric surgery is effective in reversing adverse cardiac remodelling in obesity. However, it is unclear whether the three commonly performed operations; Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Adjustable Gastric Band (LAGB) are equal in their ability to reverse remodelling. Methods: Fifty-eight patients underwent CMR to assess left ventricular mass (LVM), LV mass:volume ratio (LVMVR) and LV eccentricity index (LVei) before and after bariatric surgery (26 RYGB, 22 LSG and 10 LAGB), including 46 with short-term (median 251–273 days) and 43 with longer-term (median 983–1027 days) follow-up. Abdominal visceral adipose tissue (VAT) and epicardial adipose tissue (EAT) were also assessed. Results: All three procedures resulted in significant decreases in excess body weight (48–70%). Percentage change in VAT and EAT was significantly greater following RYGB and LSG compared to LAGB at both timepoints (VAT:RYGB −47% and −57%, LSG −47% and −54%, LAGB −31% and −25%; EAT:RYGB −13% and −14%, LSG –16% and −19%, LAGB −5% and −5%). Patients undergoing LAGB, whilst having reduced LVM (−1% and −4%), had a smaller decrease at both short (RYGB: −8%, p < 0.005; LSG: −11%, p < 0.0001) and long (RYGB: −12%, p = 0.009; LSG: −13%, p < 0.0001) term timepoints. There was a significant decrease in LVMVR at the long-term timepoint following both RYGB (−7%, p = 0.006) and LSG (−7%, p = 0.021), but not LAGB (−2%, p = 0.912). LVei appeared to decrease at the long-term timepoint in those undergoing RYGB (−3%, p = 0.063) and LSG (−4%, p = 0.015), but not in those undergoing LAGB (1%, p = 0.857). In all patients, the change in LVM correlated with change in VAT (r = 0.338, p = 0.0134), while the change in LVei correlated with change in EAT (r = 0.437, p = 0.001). Conclusions: RYGB and LSG appear to result in greater decreases in visceral adiposity, and greater reverse LV remodelling with larger reductions in LVM, concentric remodelling and pericardial restraint than LAGB. |
| spellingShingle | Henry, JA Abdesselam, I Deal, O Lewis, AJ Rayner, J Bernard, M Dutour, A Gaborit, B Kober, F Soghomonian, A Sgromo, B Byrne, J Bege, T Borlaug, BA Neubauer, S Rider, OJ The effect of bariatric surgery type on cardiac reverse remodelling |
| title | The effect of bariatric surgery type on cardiac reverse remodelling |
| title_full | The effect of bariatric surgery type on cardiac reverse remodelling |
| title_fullStr | The effect of bariatric surgery type on cardiac reverse remodelling |
| title_full_unstemmed | The effect of bariatric surgery type on cardiac reverse remodelling |
| title_short | The effect of bariatric surgery type on cardiac reverse remodelling |
| title_sort | effect of bariatric surgery type on cardiac reverse remodelling |
| work_keys_str_mv | AT henryja theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT abdesselami theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT dealo theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT lewisaj theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT raynerj theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT bernardm theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT dutoura theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT gaboritb theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT koberf theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT soghomoniana theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT sgromob theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT byrnej theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT beget theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT borlaugba theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT neubauers theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT rideroj theeffectofbariatricsurgerytypeoncardiacreverseremodelling AT henryja effectofbariatricsurgerytypeoncardiacreverseremodelling AT abdesselami effectofbariatricsurgerytypeoncardiacreverseremodelling AT dealo effectofbariatricsurgerytypeoncardiacreverseremodelling AT lewisaj effectofbariatricsurgerytypeoncardiacreverseremodelling AT raynerj effectofbariatricsurgerytypeoncardiacreverseremodelling AT bernardm effectofbariatricsurgerytypeoncardiacreverseremodelling AT dutoura effectofbariatricsurgerytypeoncardiacreverseremodelling AT gaboritb effectofbariatricsurgerytypeoncardiacreverseremodelling AT koberf effectofbariatricsurgerytypeoncardiacreverseremodelling AT soghomoniana effectofbariatricsurgerytypeoncardiacreverseremodelling AT sgromob effectofbariatricsurgerytypeoncardiacreverseremodelling AT byrnej effectofbariatricsurgerytypeoncardiacreverseremodelling AT beget effectofbariatricsurgerytypeoncardiacreverseremodelling AT borlaugba effectofbariatricsurgerytypeoncardiacreverseremodelling AT neubauers effectofbariatricsurgerytypeoncardiacreverseremodelling AT rideroj effectofbariatricsurgerytypeoncardiacreverseremodelling |