Abstract 11042: Favorable Changes in Right Ventricular Size and Function 5 years after Bariatric Surgery: Effects of Weight Loss and Regain
Background: Gastric bypass surgery (GBS) is increasingly used to treat severe obesity. There are limited data on the long term effects of GBS on right ventricular (RV) function.
Methods: In a prospective registry, severely obese pts undergoing GBS (n= 185) or nonsurgical treatment (n=301) had echocardiograms at study entry, 2 and 5 yrs. We measured RV cavity areas, fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE). Validity of echocardiographic measurements was verified against cardiac MRI in 52 patients who underwent both studies with 2 weeks. The RV annulus, FAC and TAPSE correlated well between modalities (r =0.84, 0.81, 0.80 respectively, p<0.01).
Results: Baseline clinical characteristics in the two groups were similar (75% female, HgbA1c 5.9, BP 125/70) except for slightly lower age (42 vs. 46) and higher BMI (47 vs. 44) in the GBS group. At 5 years GBS subjects lost 93 lbs vs. +0.3 lbs in nonsurgical. Weight loss was maximal at 2 yrs with regain of 15 lbs between yrs 2 and 5. RV diastolic area decreased at 2 yrs in GBS group, but then increased to baseline at 5 yrs (Table). In nonsurgical pts diastolic area increased at both 2 and 5 yrs. RV FAC increased at 2 years in GBS patients and remained stable at 5 years. In contrast, no change in FAC occurred in the nonsurgical group. TAPSE increased at 2 years in GBS group and remained stable at 5 years, but did not change in the nonsurgical group.
Conclusions: GBS was associated with reduction in RV size and improvements in RV function (FAC and TAPSE at 2 years). RV volumes increased as GBS patients regained weight between years 2 and 5, however, RV function remained improved. Nonsurgical pts had progressive RV enlargement with no improvement in function. Improved RV function may represent a mechanism by which bariatric surgery enhances outcomes in severe obesity.
- © 2010 by American Heart Association, Inc.