Effect of Bariatric Surgery on Cardiovascular Function and Heart Failure Outcomes

Mottel, Beth Hillary; Lindsay, D. A.; Frishman, William H.

doi:10.1097/crd.0000000000000338

Cited by 14 publications

(8 citation statements)

References 100 publications

(160 reference statements)

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“…Beyond improvements in risk factors relevant to HF, the significant loss of body weight associated with metabolic surgery is also directly associated with reduction in major cardiovascular events in those with HF (184), notably including those with HFpEF (185). Furthermore, mechanistically, metabolic surgery has also been linked to reversing cardiac remodeling with improved systolic and diastolic function (186,187).…”

Section: Considerations On Metabolic Surgery For Diabetes and Hfmentioning

confidence: 99%

Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association

et al. 2022

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Heart failure (HF) has been recognized as a common complication of diabetes, with a prevalence of up to 22% in individuals with diabetes and increasing incidence rates. Data also suggest that HF may develop in individuals with diabetes even in the absence of hypertension, coronary heart disease, or valvular heart disease and, as such, represents a major cardiovascular complication in this vulnerable population; HF may also be the first presentation of cardiovascular disease in many individuals with diabetes. Given that during the past decade, the prevalence of diabetes (particularly type 2 diabetes) has risen by 30% globally (with prevalence expected to increase further), the burden of HF on the health care system will continue to rise. The scope of this American Diabetes Association consensus report with designated representation from the American College of Cardiology is to provide clear guidance to practitioners on the best approaches for screening and diagnosing HF in individuals with diabetes or prediabetes, with the goal to ensure access to optimal, evidence-based management for all and to mitigate the risks of serious complications, leveraging prior policy statements by the American College of Cardiology and American Heart Association.

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Section: Considerations On Metabolic Surgery For Diabetes and Hfmentioning

confidence: 99%

Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association

et al. 2022

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“…Data from the literature suggests that the risk of atrial arrhythmia and HFpEF is increased in obesity and with the presence of LA mechanical dysfunction measured by strain. On the other hand, the increased risk of AF and HFpEF in obesity is effectively reduced by surgically induced weight loss [20][21][22][23][24].…”

Section: Key Pointsmentioning

confidence: 99%

“…During our data analysis, we performed a routine indexation to BSA, and we found that BSA indexation introduced a paradoxical increase in LA and LV dimensions after surgery. We think that this finding is of no clinical significance, considering the clinical observations of reduced incidence of atrial fibrillation and heart failure after surgically induced weight loss [ 20 – 24 ]. We believe that these findings reflect well-known difficulties in cardiac chamber indexation in severe obesity [ 48 ].…”

Section: Limitationsmentioning

confidence: 99%

The Influence of Surgical Weight Reduction on Left Atrial Strain

et al. 2021

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Background Obesity increases and surgical weight reduction decreases the risk of atrial fibrillation (AF) and heart failure (HF). We hypothesized that surgically induced weight loss may favorably affect left atrial (LA) mechanical function measured by longitudinal strain, which has recently emerged as an independent imaging biomarker of increased AF and HF risk. Methods We retrospectively evaluated echocardiograms performed before and 12.2 ± 2.2 months after bariatric surgery in 65 patients with severe obesity (mean age 39 [36; 47] years, 72% of females) with no known cardiac disease or arrhythmia. The LA mechanical function was measured by the longitudinal strain using the semi-automatic speckle tracking method. Results After surgery, body mass index decreased from 43.72 ± 4.34 to 30.04 ± 4.33 kg/m2. We observed a significant improvement in all components of the LA strain. LA reservoir strain (LASR) and LA conduit strain (LASCD) significantly increased (35.7% vs 38.95%, p = 0.0005 and − 19.6% vs − 24.4%, p < 0.0001) and LA contraction strain (LASCT) significantly decreased (− 16% vs − 14%, p = 0.0075). There was a significant correlation between an increase in LASR and LASCD and the improvement in parameters of left ventricular diastolic and longitudinal systolic function (increase in E’ and MAPSE). Another significant correlation was identified between the decrease in LASCT and an improvement in LA function (decrease in A’). Conclusions The left atrial mechanical function improves after bariatric surgery. It is partially explained by the beneficial effect of weight reduction on the left ventricular diastolic and longitudinal systolic function. This effect may contribute to decreased risk of AF and HF after bariatric surgery. Graphical abstract

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Section: Considerations On Metabolic Surgery For Diabetes and Hfmentioning

confidence: 99%

Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association

Pop‐Busui¹,

Januzzi²,

Bruemmer³

et al. 2022

Preprint

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Traditionally, the prevention and management of chronic complications in individuals with type 1 (T1D) and type 2 diabetes (T2D) has been focused on of nephropathy, retinopathy, neuropathy, and atherosclerotic cardiovascular disease (including ischemic heart disease, stroke or peripheral vascular disease) (1). However, heart failure (HF) has been recognized as a common complication of diabetes, with a prevalence of up to 22% in individuals with diabetes and increasing incidence rates (2–4). This recognition stems in part from trials focused on cardiovascular safety of newer drugs to treat diabetes. Data also suggest HF may develop in individuals with diabetes even in the absence of hypertension, coronary heart disease, or valvular heart disease and, as such, represents a major cardiovascular complication in this vulnerable population (5). Given that during the past decade, the prevalence of diabetes (particularly T2D) has risen by 30% globally (6) (with prevalence expected to increase further), the burden of HF on the health care system will continue to rise. The scope of this American Diabetes Association (ADA) consensus report with designated representation from the American College of Cardiology (ACC) is to provide clear guidance and to recommend best approaches to general internists, family physicians, and endocrinologists for HF screening, diagnosis, and management in individuals with T1D, T2D, or prediabetes to mitigate the risks of serious complications, leveraging prior policy statements by the ACC (7) and American Heart Association (AHA) (2). This consensus report was developed by the writing group convened by ADA with representation from ACC through a series of conference calls, emails, and independent work from March 2021 through March 2022. Traditionally, the prevention and management of chronic complications in individuals with type 1 (T1D) and type 2 diabetes (T2D) has been focused on of nephropathy, retinopathy, neuropathy, and atherosclerotic cardiovascular disease (including ischemic heart disease, stroke or peripheral vascular disease) (1). However, heart failure (HF) has been recognized as a common complication of diabetes, with a prevalence of up to 22% in individuals with diabetes and increasing incidence rates (2–4). This recognition stems in part from trials focused on cardiovascular safety of newer drugs to treat diabetes. Data also suggest HF may develop in individuals with diabetes even in the absence of hypertension, coronary heart disease, or valvular heart disease and, as such, represents a major cardiovascular complication in this vulnerable population (5). Given that during the past decade, the prevalence of diabetes (particularly T2D) has risen by 30% globally (6) (with prevalence expected to increase further), the burden of HF on the health care system will continue to rise. The scope of this American Diabetes Association (ADA) consensus report with designated representation from the American College of Cardiology (ACC) is to provide clear guidance and to recommend best approaches to general internists, family physicians, and endocrinologists for HF screening, diagnosis, and management in individuals with T1D, T2D, or prediabetes to mitigate the risks of serious complications, leveraging prior policy statements by the ACC (7) and American Heart Association (AHA) (2). This consensus report was developed by the writing group convened by ADA with representation from ACC through a series of conference calls, emails, and independent work from March 2021 through March 2022.

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Effect of Bariatric Surgery on Cardiovascular Function and Heart Failure Outcomes

Cited by 14 publications

References 100 publications

Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association

Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association

The Influence of Surgical Weight Reduction on Left Atrial Strain

Heart Failure: An Underappreciated Complication of Diabetes. A Consensus Report of the American Diabetes Association

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