Details

Autor(en) / Beteiligte

• Snelder, Sanne M.
• Aga, Yaar
• de Groot - de Laat, Lotte E.
• Biter, L. Ulas
• Cabezas, Manuel Castro
• Pouw, Nadine
• Birnie, Erwin
• Boxma - de Klerk, Bianca
• Klaassen, René A.
• Zijlstra, Felix
• van Dalen, Bas M.

Titel

Normalization of Cardiac Function After Bariatric Surgery Is Related to Autonomic Function and Vitamin D

Ist Teil von

• Obesity surgery, 2023-01, Vol.33 (1), p.47-56

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Purpose Subclinical cardiac dysfunction is common in patients with obesity. Bariatric surgery is associated with normalization of subclinical cardiac function in 50% of the patients with obesity. The aim of this study was to identify predictors for a lack of improvement of subclinical cardiac dysfunction 1-year post-bariatric surgery. Methods Patients who were referred for bariatric surgery were enrolled in a longitudinal study. Inclusion criteria were age 35–65 years and BMI ≥ 35 kg/m 2 . Patients with a suspicion of or known cardiovascular disease were excluded. Conventional and advanced echocardiography, Holter monitoring, and blood tests were performed pre- and 1-year post-bariatric surgery. Subclinical cardiac dysfunction was defined as either a reduced left ventricular ejection fraction, decreased global longitudinal strain (GLS), diastolic dysfunction, arrhythmia, or an increased BNP or hs Troponin I. Results A total of 99 patients were included of whom 59 patients had cardiac dysfunction at baseline. Seventy-two patients completed the 1-year follow-up after bariatric surgery. There was a significant reduction in weight and cardiovascular risk factors. Parameters of cardiac function, such as GLS, improved. However, in 20 patients cardiac dysfunction persisted. Multivariate analysis identified a decreased heart rate variability (which is a measure of autonomic function), and a decreased vitamin D pre-surgery as predictors for subclinical cardiac dysfunction after bariatric surgery. Conclusion Although there was an overall improvement of cardiac function 1-year post-bariatric surgery, autonomic dysfunction and a decreased vitamin D pre-bariatric surgery were predictors for a lack of improvement of subclinical cardiac dysfunction. Graphical abstract