Abstract 1303: Do Acute Improvements in LV Mass and Diastolic Function Following Adolescent Bariatric Surgery Persist at Two Years Post-op?
We previously demonstrated acute changes in cardiac structure and function following significant weight loss in morbidly obese adolescents after bariatric surgery. It is controversial if these changes persist. The purpose of this study was to assess mid-term changes in cardiac findings after bariatric surgery.
Methods: All adolescents ≤19 yrs old undergoing bariatric surgery were eligible. Echoes were performed pre-op and at 6, 12, and 24 mos post-op for LV geometry (mass & subgroups of hypertrophy) & diastolic function (tissue Doppler mitral Ea/Aa, E/Ea). Repeated-measures, mixed linear models, and generalized estimating equations were used to assess these relationships.
Results: 83 adolescents (16.9±1.5yrs; 63 F, 20 M) met criteria & had a pre-op echo. Of those 55 had echoes at 6 mos, 41 at 12 mos, & 21 at 24 mos. Compared to pre-op, BMI significantly decreased at 2 yrs post-op (58±11 vs 38±7 kg/m2, p<0.01). Changes in LV mass & diastolic function significantly improved within 6 mos (p ≤ 0.01 for all) and persisted at 2 yrs post-op. (Figure 1⇓ & 2⇓) All changes in LV mass & diastolic function at 6 mos post-op correlated with change in BMI (p≤0.05 for all). Change in indexed LVM was not impacted by blood pressure. The prevalence of adolescents with abnormal LV geometry subtypes decreased from 49% at pre-op to 24% at 2 yrs post-op (p<0.01).
Conclusions: Cardiac abnormalities in morbidly obese adolescents decrease with weight loss & persist for at least 2 years following bariatric surgery. These results are encouraging, suggesting that early weight loss intervention produces lasting improvements in cardiac risk factors.