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.


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