Improvement of Exercise Capacity and Peripheral Metaboreflex After Bariatric Surgery

Silva, Roberto P. da; Martinez, Dênis; Faria, Christiane Carvalho; Carli, Luiz Alberto De; Souza, Winston Isio Boff Pereira de; Meinhardt, Nelson Guardiola; Souto, Kátia Elisabete Pires; Trindade, Manoel Roberto Maciel; Ribeiro, Jorge Pinto

doi:10.1007/s11695-013-0988-x

Cited by 27 publications

(28 citation statements)

References 27 publications

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“…A study by MacMahon et al [32] showed that weight loss of as little as 8 kg is associated with a significant decrease in left ventricular mass after 6 months, while Alpert et al [33] demonstrated that cardiac function in morbidly obese individuals improved with an average weight loss of 55 kg. However, few studies performed a 6-min walk test for estimation of exercise capacity [34]. …”

Section: Discussionmentioning

confidence: 99%

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Nedeljkovic‐Arsenovic¹,

Banović²,

Radenković³

et al. 2019

Obes Facts

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Background: Bariatric surgery, especially Roux-en-Y gastric bypass (RYGB), has become the most frequently used therapy for morbid obesity. Objectives: The aim of this study was to examine the effects of surgically induced weight loss on cardiopulmonary function 6 months after the procedure, as well as the effect of such an intervention on well-known risk factors for cardiovascular diseases. Methods: This is a cross-sectional study on 66 morbidly obese patients (BMI ≥40 or ≥35 kg/m² with present comorbidities), comparing their cardiopulmonary function prior to and 6 months after RYGB surgery. Results: The substantial amount of weight loss (29.80 ± 13.27 kg) after RYGB surgery was associated with significant reduction of comorbidities, especially diabetes and sedentary lifestyle (p = 0.005 and p = 0.002, respectively). Regarding functional capacity, there was significant increase in peak oxygen uptake (VO₂ peak, p = 0.003), duration of exercise testing, metabolic equivalents (exercise time and METs, p < 0.001), and in peak O₂ pulse. These findings were particularly pronounced in a group of patients who had lost more than 18% of initial weight. Conclusions: Reduction of body weight after RYGB surgery is associated with significantly improved cardiorespiratory function 6 months after surgery, especially in patients who lost more than 18% of their initial body weight. In addition, substantial decreases in body weight were also associated with a reduction of cardiovascular risk factors such as diabetes, smoking, hypertriglyceridemia, and sedentary lifestyle.

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Section: Discussionmentioning

confidence: 99%

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Nedeljkovic‐Arsenovic¹,

Banović²,

Radenković³

et al. 2019

Obes Facts

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“…Others have shown that adults 3mo following bariatric surgery exhibited significantly reduced resting HR and, during a 6min walk test, had significantly improved HR responses during and immediately following the test as well as demonstrated improved HR recovery. 24 Interestingly, these changes in HR were accompanied by peripheral muscular metaboreflex responses, which are indicative of enhanced muscle profusion. Studies in adults 30,31 and adolescents 32,33 have shown beneficial adaptations in cardiac structure and function following bariatric surgery, which when coupled with improvements in systemic vascular function, 34,35 may play an important role in regulating HR responses during rest and post-exercise.…”

Section: Discussionmentioning

confidence: 99%

Changes in Functional Mobility and Musculoskeletal Pain After Bariatric Surgery in Teens With Severe Obesity

et al. 2016

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IMPORTANCE Severe obesity is associated with mobility limitations and higher incidence of multijoint musculoskeletal pain. It is unknown whether substantial weight loss improves these important outcomes in adolescents with severe obesity.OBJECTIVE To examine the association of bariatric surgery with functional mobility and musculoskeletal pain in adolescents with severe obesity up to 2 years after surgery. DESIGN, SETTING, AND PARTICIPANTSThe Teen-Longitudinal Assessment of Bariatric Surgery Study is a prospective, multicenter, observational study, which enrolled 242 adolescents (Յ19 years of age) who were undergoing bariatric surgery from March 2007 through February 2012 at 5 US adolescent bariatric surgery centers. This analysis was conducted in November 2015.INTERVENTIONS Roux-en-Y gastric bypass (n = 161), sleeve gastrectomy (n = 67), or laparoscopic adjustable gastric band (n = 14). MAIN OUTCOMES AND MEASURESParticipants completed a 400-m walk test prior to bariatric surgery (n = 206) and at 6 months (n = 195), 12 months (n = 176), and 24 months (n = 149) after surgery. Time to completion, resting heart rate (HR), immediate posttest HR, and HR difference (resting HR minus posttest HR) were measured and musculoskeletal pain concerns, during and after the test, were documented. Data were adjusted for age, sex, race/ethnicity, baseline body mass index (calculated as weight in kilograms divided by height in meters squared), and surgical center (posttest HR and HR difference were further adjusted for changes in time to completion). RESULTSOf the 206 adolescents with severe obesity included in the study, 156 were female (75.7%), the mean (SD) age was 17.1 (1.6) years, and the mean (SD) body mass index was 51.7 (8.5). Compared with baseline, significant improvements were observed at 6 months for the walk test time to completion (mean, 376 seconds; 95% CI, 365-388 to 347 seconds; 95% CI, 340-358; P < .01), resting HR (mean, 84 beats per minute [bpm]; 95% CI, 82-86 to 74 bpm; 95% CI, 72-76), posttest HR (mean, 128 bpm; 95% CI, 125-131 to 113 bpm; 95% CI, 110-116), and HR difference (mean, 40 bpm; 95% CI, 36-42 to 34 bpm; 95% CI, 31-37). These changes in time to completion, resting HR, and HR difference persisted at 12 months and 24 months. Posttest HR further improved from 6 months to 12 months (mean, 113 bpm; 95% CI, 110-116 to 108 bpm; 95% CI, 105-111). There were statistically significant reductions in musculoskeletal pain concerns at all points.CONCLUSIONS AND RELEVANCE These data provide evidence that bariatric surgery in adolescents with severe obesity is associated with significant improvement in functional mobility and in the reduction of walking-related musculoskeletal pain up to 2 years after surgery.

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“…Thirty studies with a total of 1779 patients were identified as suitable for meta‐analysis of the effect of bariatric surgery on physical function. Objective measurement of physical function was undertaken in 21 of the 30 studies, and nine studies employed self‐reporting by patients.…”

Section: Resultsmentioning

confidence: 99%

“… Table S1 Characteristics of studies included in the meta‐analysis of physical function before and after bariatric surgery Table S2 Characteristics of studies excluded from the meta‐analysis of physical function before and after bariatric surgery Table S3 Assessment of risk of bias in studies included in the meta‐analysis of physical function before and after bariatric surgery …”

mentioning

confidence: 99%

Meta-analysis of the effect of bariatric surgery on physical function

Adil

Jain

Rashid

et al. 2018

British Journal of Surgery

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Improvement of Exercise Capacity and Peripheral Metaboreflex After Bariatric Surgery

Abstract: Weight loss after bariatric surgery increases exercise capacity and reduces peripheral metaboreflex, heart rate, and blood pressure. Further investigation on the role of metaboreflex regarding mechanisms of exercise capacity of individuals with obesity is warranted.

Cited by 27 publications

References 27 publications

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

Changes in Functional Mobility and Musculoskeletal Pain After Bariatric Surgery in Teens With Severe Obesity

Meta-analysis of the effect of bariatric surgery on physical function

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