Blood pressure reduction after gastric bypass surgery is explained by a decrease in cardiac output

Brussel, Peter M. van; Bogaard, Bas van den; Weijer, Barbara A. de; Truijen, Jasper; Krediet, C. T. Paul; Janssen, Ignace; Laar, Arnold van de; Kaasjager, Karin A H; Fliers, Eric; Lieshout, Johannes J. van; Serlie, Mireille J.; Born, Bert‐Jan H. van den

doi:10.1152/japplphysiol.00362.2016

Cited by 8 publications

(4 citation statements)

References 42 publications

(46 reference statements)

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“…The changes in HR we observed following reduction in BMI are similar to those reported in overweight young adults [17]. Stroke volume [18], measured by Doppler echocardiography, did not decrease significantly, so the significant decrease in CO both post-diet and post-surgery reflects the changes in HR. Contrary to expectation, the lack of change in LV mass and geometry over the study may be explained by the relatively short follow-up period.…”

Section: Discussionsupporting

confidence: 84%

Weight Loss After Bariatric Surgery Significantly Improves Carotid and Cardiac Function in Apparently Healthy People with Morbid Obesity

et al. 2020

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Purpose Obesity clearly increases cardiovascular risk, often inducing high blood pressure (BP), impaired left ventricular (LV) function, and increased arterial stiffness. Intensive weight loss and bariatric surgery induce improvement in hypertension and diabetes for morbid obesity. Carotid artery haemodynamics is a powerful prognostic indicator for stroke and cognitive decline independent of BP. The aim of this study was to evaluate the impact of a 3-stage bariatric strategy of diet, bariatric surgery, and consequent weight loss on carotid haemodynamics and cardiac diastolic function. Material and Methods This prospective study included 26 patients (45 ± 10 years, 4 men) with severe obesity undergoing bariatric surgery without comorbidities (hypertension, diabetes, etc.). Anthropometry, BP, Doppler echocardiography, and common carotid haemodynamics by ultrasound were measured at three times: (1) baseline, (2) after 1-month diet (post-diet), and (3) 8 months after surgery (post-surgery). The lnDU-loop method was used to estimate local carotid pulse wave velocity (ncPWV). Results Baseline BMI was 47.9 ± 7.1 kg/m2 and reduced by 5% and 30% post-diet and post-surgery, respectively. BP decreased only post-diet, without pulse pressure change. However, ncPWV, 6.27 ± 1.35 m/s at baseline, was significantly reduced by 10% and 23% post-diet and post-surgery, respectively, also adjusted for BP changes. The E/A ratio rose from 0.95 ± 0.20 to 1.27 ± 0.31 (p < 0.005), without change in LV geometry or mass, while heart rate and cardiac output fell substantially. Conclusion Weight loss following diet and bariatric surgery is associated with reduced carotid arterial stiffness and improved LV diastolic function. Diet and bariatric surgery are effective treatments for morbid obesity with its concomitant adverse cardiovascular effects.

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Section: Discussionsupporting

confidence: 84%

Weight Loss After Bariatric Surgery Significantly Improves Carotid and Cardiac Function in Apparently Healthy People with Morbid Obesity

et al. 2020

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“…Blood pressure and central hemodynamics were assessed via a Nexfin device (Edwards Lifesciences, Irvine, CA, USA) that utilizes the volume-clamp method to measure blood pressure and heart rate, while cardiac output was estimated using the CO-trek algorithm [ 65 ]. Heart rate variability, a marker of sympathovagal balance, was determined by calculating the standard deviation of the normal-to-normal intervals (SDNN, inter-beat intervals derived from continuous blood pressure recordings after filtering) [ 66 ].…”

Section: Methodsmentioning

confidence: 99%

Infusion of donor feces affects the gut–brain axis in humans with metabolic syndrome

Hartstra

Schüppel

Imangaliyev

et al. 2020

Molecular Metabolism

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Objective Increasing evidence indicates that intestinal microbiota play a role in diverse metabolic processes via intestinal butyrate production. Human bariatric surgery data suggest that the gut-brain axis is also involved in this process, but the underlying mechanisms remain unknown. Methods We compared the effect of fecal microbiota transfer (FMT) from post-Roux-en-Y gastric bypass (RYGB) donors vs oral butyrate supplementation on ( 123 I-FP-CIT-determined) brain dopamine transporter (DAT) and serotonin transporter (SERT) binding as well as stable isotope-determined insulin sensitivity at baseline and after 4 weeks in 24 male and female treatment-naïve metabolic syndrome subjects. Plasma metabolites and fecal microbiota were also determined at these time points. Results We observed an increase in brain DAT after donor FMT compared to oral butyrate that reduced this binding. However, no effect on body weight and insulin sensitivity was demonstrated after post-RYGB donor feces transfer in humans with metabolic syndrome. Increases in fecal levels of Bacteroides uniformis were significantly associated with an increase in DAT, whereas increases in Prevotella spp. showed an inverse association. Changes in the plasma metabolites glycine, betaine, methionine, and lysine (associated with the S -adenosylmethionine cycle) were also associated with altered striatal DAT expression. Conclusions Although more and larger studies are needed, our data suggest a potential gut microbiota-driven modulation of brain dopamine and serotonin transporters in human subjects with obese metabolic syndrome. These data also suggest the presence of a gut-brain axis in humans that can be modulated. NTR registration 4488.

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“…All potential sources of bias, including selection bias, performance bias, detection bias and information bias, were assessed (Table 2). Eleven studies 19,21,22,24,25,27,29,32–35 had a low risk of bias, 7 studies 10,12,18,20,26,30,31 had a moderate risk of bias and 2 studies had a high risk of bias 23,28 …”

Section: Resultsmentioning

confidence: 99%

Orthostatic intolerance after bariatric surgery: A systematic review and meta‐analysis

et al. 2021

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Summary There have been increased reports of orthostatic intolerance post‐bariatric surgery. However, the prevalence, pathophysiology and long‐term outcomes have not been well described. Therefore, we sought to summarize evidence of orthostatic intolerance after bariatric surgery. We conducted a systematic review using PubMed, Scopus, CINAHL, Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (CENTRAL) to identify relevant articles from the date of inception until 1st April 2020. Study selection, data extraction and quality assessment of the included studies were performed independently by two reviewers. The findings of the included studies were narratively reported. When feasible, a meta‐analysis was done to summarize the relevant results. We included 20 studies (n = 19 843 participants) reporting findings of 12 prospective cohort studies, 5 retrospective cohort studies, 2 cross‐sectional studies and one randomized controlled trial. The 5‐year cumulative incidence of orthostatic intolerance was 4.2% (one study). Common clinical presentations of orthostatic intolerance were lightheadedness, dizziness, syncope and palpitation. The pooled data suggested improvement in overall cardiac autonomic function (sympathetic and parasympathetic) post‐bariatric surgery. In addition, a significant systolic blood pressure drop may reflect a reset of the balance between the sympathetic and parasympathetic nervous systems after weight loss in the pooled analysis. Existing literature on orthostatic intolerance post‐bariatric surgeries was limited or of low quality, and larger studies are needed to know the true incidence of orthostatic intolerance post‐bariatric surgeries and the pathophysiology. We found one study reporting the 5‐years cumulative incidence of orthostatic intolerance post‐bariatric surgeries as only 4.2%. This could challenge the idea of increased orthostatic intolerance prevalence post‐bariatric surgeries. Registration The review protocol was registered at the International Prospective Register of Systemic Reviews PROSPERO (CRD42020170877).

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Blood pressure reduction after gastric bypass surgery is explained by a decrease in cardiac output

Cited by 8 publications

References 42 publications

Weight Loss After Bariatric Surgery Significantly Improves Carotid and Cardiac Function in Apparently Healthy People with Morbid Obesity

Weight Loss After Bariatric Surgery Significantly Improves Carotid and Cardiac Function in Apparently Healthy People with Morbid Obesity

Infusion of donor feces affects the gut–brain axis in humans with metabolic syndrome

Orthostatic intolerance after bariatric surgery: A systematic review and meta‐analysis

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