Abstract 18541: Gastric Bypass Surgery is Associated with a Marked Reduction in Circulating High Sensitivity Cardiac Troponin I Concentrations: Comparison with Intensive Lifestyle Intervention
Introduction: Morbid obesity is associated with increased cardiac mass and cardiovascular risk. Circulating high sensitivity cardiac troponin I (hs-TnI) concentrations reflect cardiac mass and hemodynamic stress and are strongly predictive of subsequent risk of heart failure and premature death. The impact of weight loss induced by gastric bypass surgery (GBS) and intensive lifestyle intervention (ILI) on circulating hs-TnI is unknown.
Hypothesis: Weight loss induced by GBS and ILI is associated with reduced circulating hs-TnI concentrations.
Methods: The Morbid Obesity treatment, Bariatric surgery versus Intensive Lifestyle intervention study was a controlled clinical trial conducted from December 2005 to June 2009 at the Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway. A group of 139 morbidly obese subjects were treated either with GBS or ILI. Biochemical and clinical indices of cardiovascular and metabolic health were assessed at baseline and after 12 months of follow-up. Blood samples for hs-TnI analyses were available from 136 participants (94 female), out of whom 74 received GBS.
Results: At baseline median hs-TnI levels were 2.35 (1.38-4.40) ng/L in the ILI group and 2.40 (1.28-3.95) ng/L in the GBS group (ns). After 12 months of follow-up, hs-TnI had decreased significantly more in the GBS group than in the ILI group (1.10 ng/L vs. 0.20 ng/L; p=0.002) (see Figure). Variables associated with the change in hs-TnI concentrations by univariate analyses included intervention group (p=0.002), changes in body mass index (p=0.002), body weight (p=0.003), waist circumference (p=0.04), serum total cholesterol (p=0.009), serum triglycerides (p=0.002) and HbA1c (p=0.017).
Conclusions: In patients with morbid obesity, GBS was associated with a significantly greater reduction in hs-TnI than ILI, suggesting that bariatric surgery and/or large weight loss unloads the stressed heart and may lead to reduced cardiac mass and hemodynamic stress.
Author Disclosures: M.N. Lyngbakken: None. T. Omland: Research Grant; Modest; Research support via Akershus University Hospital from Abbott Diagnostics and AstraZeneca.. Honoraria; Modest; Speaker and/or consultancy honoraria from Abbott Diagnostics, Roche Diagnostics. Siemens Healthcare Diagnostics and AstraZeneca. N. Nordstrand: None. J. Norseth: None. J. Hjelmesæth: None. D. Hofsø: None.
- © 2014 by American Heart Association, Inc.