Abstract 16006: Patients with Heart Failure with Preserved Ejection Fraction have Improved Symptoms, Exercise Tolerance, Diastolic Function, and Liver (but not Cardiac) Fat 3 and 6 Months after Gastric Bypass
Background: Although it may seem obvious that obese patients with heart failure with preserved ejection fraction (HFpEF) should lose weight, data supporting this are lacking, and obesity is associated with improved survival in heart failure.
Methods: Eleven patients (10 women; 7 diabetics; 9 white; age 49 +/- 9 years) with obesity and HFpEF completed testing before and 3 and 6 months after gastric bypass surgery. We measured quality of life using the Minnesota Living with Heart Failure questionnaire (MLHFQ); fat mass using dual energy X-ray absorptiometry; hepatic and left ventricular (LV) triglyceride content using magnetic resonance spectroscopy; and relatively load-independent diastolic function using tissue Doppler imaging.
Results: There were significant decreases in weight, body fat, and hepatic triglyceride content 3 months after gastric bypass surgery. LV relaxation (E'), 6 minute walk time, and quality of life improved (lower MLHFQ score). After 6 months, each of these salutary changes became even more pronounced (overall time period effect p-values: p<.001 for weight, body fat; p=.01 hepatic triglyceride; p=.02 E'; p=.03 6 minute walk; p=.014 MLWHF). LV triglyceride content, blood pressure, ejection fraction, and relative wall thickness did not change.
Conclusion: In patients with obesity and HFpEF, weight loss from gastric bypass surgery improves quality of life and diastolic function. This intrinsic functional improvement is independent of changes in load, blood pressure, steatosis, or remodeling over 6 months of follow-up. Gastric bypass-induced weight loss is likely an effective therapy for obesity-related HFpEF.
- © 2012 by American Heart Association, Inc.