Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity

Schneiter, Stephan; Warrier, Ranjana; Lefkovits, Lisa; Laurie, Cheryl; O'Brien, Paul Edmond; Taylor, Andrew J.

doi:10.4236/ijcm.2011.24062

Cited by 8 publications

(7 citation statements)

References 39 publications

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“…Following bariatric surgery, studies have reported conflicting results regarding LV end-diastolic volume, with increased ( 28 ), decreased ( 22 , 25 ) and no change being reported ( 26 , 27 ). This study shows a biphasic response of the LV cavity following weight loss, with the initially observed decrease in LV cavity size being followed by a longer-term increase in cavity size, back to the baseline size.…”

Section: Discussionmentioning

confidence: 99%

“…With the reduction in both subcutaneous (driving volume load and eccentric hypertrophy) and visceral adiposity (driving insulin resistance and concentric remodelling) following bariatric surgery, this would be expected. The results for left ventricular cavity size changes are far less consistent, with some reporting a reduction in LV cavity size ( 22 , 25 ) whilst others no change ( 26 , 27 ), or an increase ( 28 ). In this case, the early reduction in volume load that accompanies total fat mass reduction would be expected to reduce LV cavity size, however, the reversal of insulin resistance that accompanies bariatric surgery ( 29 ), may be expected over time to reduce concentric remodelling and thus increase LV cavity size.…”

Section: Introductionmentioning

confidence: 89%

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Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry

Henry¹,

Abdesselam²,

Deal³

et al. 2023

Front. Endocrinol.

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IntroductionObesity affects cardiac geometry, causing both eccentric (due to increased cardiac output) and concentric (due to insulin resistance) remodelling. Following bariatric surgery, reversal of both processes should occur. Furthermore, epicardial adipose tissue loss following bariatric surgery may reduce pericardial restraint, allowing further chamber expansion. We investigated these changes in a serial imaging study of adipose depots and cardiac geometry following bariatric surgery.Methods62 patients underwent cardiac magnetic resonance (CMR) before and after bariatric surgery, including 36 with short-term (median 212 days), 37 medium-term (median 428 days) and 32 long-term (median 1030 days) follow-up. CMR was used to assess cardiac geometry (left atrial volume (LAV) and left ventricular end-diastolic volume (LVEDV)), LV mass (LVM) and LV eccentricity index (LVei – a marker of pericardial restraint). Abdominal visceral (VAT) and epicardial (EAT) adipose tissue were also measured.ResultsPatients on average had lost 21kg (38.9% excess weight loss, EWL) at 212 days and 36kg (64.7% EWL) at 1030 days following bariatric surgery. Most VAT and EAT loss (43% and 14%, p<0.0001) occurred within the first 212 days, with non-significant reductions thereafter. In the short-term LVM (7.4%), LVEDV (8.6%) and LAV (13%) all decreased (all p<0.0001), with change in cardiac output correlated with LVEDV (r=0.35,p=0.03) and LAV change (r=0.37,p=0.03). Whereas LVM continued to decrease with time (12% decrease relative to baseline at 1030 days, p<0.0001), both LAV and LVEDV had returned to baseline by 1030 days. LV mass:volume ratio (a marker of concentric hypertrophy) reached its nadir at the longest timepoint (p<0.001). At baseline, LVei correlated with baseline EAT (r=0.37,p=0.0040), and decreased significantly from 1.09 at baseline to a low of 1.04 at 428 days (p<0.0001). Furthermore, change in EAT following bariatric surgery correlated with change in LVei (r=0.43,p=0.0007).ConclusionsCardiac volumes show a biphasic response to weight loss, initially becoming smaller and then returning to pre-operative sizes by 1030 days. We propose this is due to an initial reversal of eccentric remodelling followed by reversal of concentric remodelling. Furthermore, we provide evidence for a role of EAT contributing to pericardial restraint, with EAT loss improving markers of pericardial restraint.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry

Henry¹,

Abdesselam²,

Deal³

et al. 2023

Front. Endocrinol.

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“…The study by Snel et al 31 demonstrated that 16 weeks of very low calorie diet reduced body weight, PAT, AVAT, ASAT to 78, 83, 40, and 53% of baseline values, respectively. Schneiter et al 32 showed that BMI, EAT, and PAT + EAT were significantly reduced after gastric banding intervention. It is unknown whether exercise program and bariatric surgery have similar effects on the different visceral excessive fat deposits and their relative distribution.…”

Section: Discussionmentioning

confidence: 99%

Differential Effects of Bariatric Surgery Versus Exercise on Excessive Visceral Fat Deposits

et al. 2016

Medicine

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The aim of the present study was to compare differential impacts of bariatric surgery and exercise-induced weight loss on excessive abdominal and cardiac fat deposition.Excessive fat accumulation around the heart may play an important role in the pathogenesis of cardiovascular disease. Recent evidences have suggested that bariatric surgery results in relatively less decrease in epicardial fat compared with abdominal visceral fat and paracardial fat.Sixty-four consecutive overweight or obese subjects were enrolled in the study. Clinical characteristics and metabolic profiles were recorded. The volumes of abdominal visceral adipose tissue (AVAT), abdominal subcutaneous adipose tissue (ASAT), epicardial (EAT), and paracardial adipose tissue (PAT) were measured by computed tomography in the bariatric surgery group (N = 25) and the exercise group (N = 39) at baseline and 3 months after intervention. Subjects in both the surgery and exercise groups showed significant reduction in body mass index (15.97%, 7.47%), AVAT (40.52%, 15.24%), ASAT (31.40, 17.34%), PAT (34.40%, 12.05%), and PAT + EAT (22.31%, 17.72%) (all P < 0.001) after intervention compared with baseline. In both the groups, the decrease in EAT was small compared with the other compartments (P < 0.01 in both groups). Compared with the exercise group, the surgery group had greater loss in abdominal and cardiac visceral adipose tissue (AVAT, ASAT, PAT, EAT+PAT) (P < 0.001), but lesser loss in EAT (P = 0.037).Compared with the exercise group, bariatric surgery results in significantly greater percentage loss of excessive fat deposits except for EAT. EAT, but not PAT, was relatively preserved despite weight reduction in both the groups. The physiological impact of persistent EAT deserves further investigation.

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“…Left ventricular diastolic dysfunction is congruent with long-lasting severe obesity and is associated with reduced eGFR [175]. Independently of a healthy or unhealthy status, the duration of severe obesity was a major risk of incident HF in the Nord-Excluding Schneiter et al [187], β Mean.…”

Section: Duration Of Obesity and Preserved Ejection Fraction Heart Fa...mentioning

confidence: 95%

“…Only a few studies examined the cardiac effects of MBS with CMR in patients with severe obesity. Eight adult studies comprising 170 subjects with severe obesity appraised LVM by CMR before and after MBS (Table 2) [181][182][183][184][185][186][187][188]. The mean reduction in LVM was 11.1% in these studies.…”

Section: Metabolic Bariatric Surgery and Left Ventricular Massmentioning

confidence: 99%

Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

Stencel

Alai

Dhorepatil

et al. 2023

JCM

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Owing to the overwhelming obesity epidemic, preserved ejection fraction heart failure commonly ensues in patients with severe obesity and the obese phenotype of preserved ejection fraction heart failure is now commonplace in clinical practice. Severe obesity and preserved ejection fraction heart failure share congruent cardiovascular, immune, and renal derangements that make it difficult to ascertain whether the obese phenotype of preserved ejection fraction heart failure is the convergence of two highly prevalent conditions or severe obesity enables the development and progression of the syndrome of preserved ejection fraction heart failure. Nevertheless, the obese phenotype of preserved ejection fraction heart failure provides a unique opportunity to assess whether sustained and sizeable loss of excess body weight via metabolic bariatric surgery reverses the concentric left ventricular remodeling that patients with preserved ejection fraction heart failure commonly display.

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Effects of Weight Loss on Pericardial Fat and Left Ventricular Mass Assessed with Cardiac Magnetic Resonance Imaging in Morbid Obesity

Abstract: ABSTRACT

Cited by 8 publications

References 39 publications

Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry

Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry

Differential Effects of Bariatric Surgery Versus Exercise on Excessive Visceral Fat Deposits

Obesity, Preserved Ejection Fraction Heart Failure, and Left Ventricular Remodeling

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