Improvement in cardiovascular indices after Roux-en-Y gastric bypass or sleeve gastrectomy for morbid obesity
Obes Surg. 2013 Jan;23(1):31-8
Improvement in cardiovascular indices after Roux-en-Y gastric bypass or sleeve gastrectomy for morbid obesity.
Kokkinos A, Alexiadou K, Liaskos C, Argyrakopoulou G, Balla I, Tentolouris N, Moyssakis I, Katsilambros N, Vafiadis I, Alexandrou A, Diamantis T.
BACKGROUND: Morbidly obese patients display cardiac abnormalities which are
partially reversed after weight loss. The aim of the present study was to assess
the potential difference in cardiovascular disease indices between patients who
underwent either gastric bypass surgery or sleeve gastrectomy.
METHODS: Thirty-seven morbidly obese patients who underwent either Roux-en-Y
gastric bypass (RYGB) (n = 14) or SG (n = 23) were examined before, 3 and 6
months after surgery. Indices of cardiac autonomic nervous system activity were
evaluated, namely baroreflex sensitivity (BRS) and heart rate variability (HRV).
A complete echocardiographic study was performed in a subgroup of 17 patients
(RYGB 8, SG 9) preoperatively and 6 months after surgery, evaluating epicardial
fat thickness, aortic distensibility, left ventricular (LV) Tei index, left
atrium diameter, ejection fraction, and LV mass.
RESULTS: All subjects experienced significant (p < 0.001) and similar weight loss
independently of the type of operation. BRS and HRV indices improved
significantly and to the same degree after surgery in both groups. In the
echocardiographic study, all parameters improved significantly at 6 months in
comparison with the baseline values. In addition, the RYGB group displayed
significantly greater reduction in epicardial fat thickness (p = 0.007) and also
tended to have a better LV performance as expressed by the lower values of the
Tei index (p = 0.06) compared to the SG group 6 months after surgery.
CONCLUSIONS: Both RYGB and SG exert comparable effects on weight loss and
improvement of cardiovascular parameters. RYGB displays a more beneficial
influence on epicardial fat thickness and left ventricular performance than SG.