Improvements in Heart Rate Variability in Women with Obesity: Short-term Effects of Sleeve Gastrectomy

Ibacache, Paulina; Cárcamo, Paulina; Miranda, Claudia Montero; Bottinelli, Andrés; Guzmán, Jaime; Martínez-Rosales, Elena; Artero, Enrique G.; Cano‐Cappellacci, Marcelo

doi:10.1007/s11695-020-04721-y

Cited by 7 publications

(12 citation statements)

References 59 publications

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“…Recently, one of the preferred procedures is LSG with relatively few postoperative complications. As numerous studies have shown, ANS dysfunction is often found because of morbid obesity, while weight loss improves sympathetic and parasympathetic activity and consequently decreases mean heart rate [ 6 , 10 , 13 , 25 ]. After analyzing the results of previous studies, we expected not only HRV and HRT recovery, but also a reduction in the incidence of hypertension and improvement in glucose homeostasis.…”

Section: Discussionmentioning

confidence: 99%

“…Our study confirmed these assumptions, and we additionally showed that positive changes are present regardless of the degree of weight loss expressed by the median reduction of BMI or WC ( Table 3 ). It has also been hypothesized that changes in the vagal-modulated neuroendocrine system have an additional effect on the beneficial effects after bariatric surgery [ 6 , 10 , 13 , 25 ]. Both the Roux-en-Y surgery and sleeve gastrectomy may induce metabolic improvements via different mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…The effects of weight loss following various techniques of bariatric surgery on hyperinsulinemia, insulin resistance and obesity associated neuropathy are still of interest. Available data suggest that various techniques of bariatric surgery improve metabolic control, including glycemic homeostasis and increased insulin sensitivity [ 5 , 6 , 7 , 8 , 9 ]. However, limited recent results are available on assessment of the dynamics of fasting glucose, insulin levels, insulin resistance/sensitivity indices and also ANS indices in patients with class III obesity, who lost weight due to laparoscopic sleeve gastrectomy (LSG), especially at a relatively young age and without severe accompanying diseases.…”

Section: Introductionmentioning

confidence: 99%

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Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

Bienias

Rymarczyk

Domienik‐Karłowicz

et al. 2021

JCM

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The effects of weight loss following bariatric surgery on autonomic balance, arrhythmias and insulin resistance are still of interest. We prospectively investigated 50 patients with BMI > 40 kg/m2, aged 36.5 (18–56) years who underwent laparoscopic sleeve gastrectomy. Among other examinations, all subjects had 24-h Holter monitoring with heart rate variability (HRV) and heart rate turbulence (HRT) evaluation. After a median of 15 months, BMI decreased from 43.9 to 29.7 kg/m2, the incidence of hypertension decreased from 54 to 32% (p = 0.04) and any carbohydrate disorders decreased from 24 to 6% (p = 0.02). Fasting insulin concentration and insulin resistance index improved significantly (p < 0.001). Improvements in HRV parameters related to the sympathetic autonomic division were also observed (p < 0.001), while HRT evaluation was not conclusive. The enhancement of autonomic tone indices was correlated with reduction of BMI (SDNN-I r = 0.281 p = 0.04; SDNN r = 0.267 p = 0.05), but not with reduction of waist circumference, and it was also associated with decrease of mean heart rate (OR 0.02, 95%CI 0.0–0.1, p < 0.001). The incidence of arrhythmias was low and similar before and after follow-up. In conclusion, improvement of homeostasis of carbohydrate metabolism and autonomic function is observed in relatively young patients after weight loss due to laparoscopic sleeve gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

Bienias

Rymarczyk

Domienik‐Karłowicz

et al. 2021

JCM

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“…Reduced vagal function and increased sympathetic activity were observed in obese subjects. The improvement in parasympathetic tone following LSG was evidenced by enhanced heart rate variability in women with obesity, as early as the first month after surgery ( Ibacache et al, 2020 ). LSG has shown a greater effect on the parasympathetic tone than RYGB, probably because LSG preserves the vagal trunk at the lesser curvature of stomach ( Geronikolou et al, 2017 ).…”

Section: Sympathetic Nervous System and Laparoscopic Sleeve Gastrectomymentioning

confidence: 99%

Role of the Autonomic Nervous System in Mechanism of Energy and Glucose Regulation Post Bariatric Surgery

Wang

Mokadem

2021

Front. Neurosci.

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Even though lifestyle changes are the mainstay approach to address obesity, Sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are the most effective and durable treatments facing this pandemic and its associated metabolic conditions. The traditional classifications of bariatric surgeries labeled them as “restrictive,” “malabsorptive,” or “mixed” types of procedures depending on the anatomical rearrangement of each one of them. This conventional categorization of bariatric surgeries assumed that the “restrictive” procedures induce their weight loss and metabolic effects by reducing gastric content and therefore having a smaller reservoir. Similarly, the “malabsorptive” procedures were thought to induce their main energy homeostatic effects from fecal calorie loss due to intestinal malabsorption. Observational data from human subjects and several studies from rodent models of bariatric surgery showed that neither of those concepts is completely true, at least in explaining the multiple metabolic changes and the alteration in energy balance that those two surgeries induce. Rather, neuro-hormonal mechanisms have been postulated to underly the physiologic effects of those two most performed bariatric procedures. In this review, we go over the role the autonomic nervous system plays- through its parasympathetic and sympathetic branches- in regulating weight balance and glucose homeostasis after SG and RYGB.

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“…Heart rhythm is recorded over 10 min at a sampling frequency of 1000 Hz with the patient seated. Kubios Premium software (v.3.2, Heart Rate Analysis, University of Eastern Finland) is used to process the raw HRV data[24,25]. 5.…”

mentioning

confidence: 99%

Supervised Exercise Immediately After Bariatric Surgery: the Study Protocol of the EFIBAR Randomized Controlled Trial

et al. 2021

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Background Previous studies have investigated weight loss caused by exercise following bariatric surgery. However, in most cases, the training program is poorly reported; the exercise type, volume, and intensity are briefly mentioned; and the sample size, selection criteria, and follow-up time vary greatly across studies. Purpose The EFIBAR study aims to investigate over 1 year the effects of a 16-week supervised exercise program, initiated immediately after bariatric surgery, on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, and quality of life in patients with severe/extreme obesity. Material and Methods The EFIBAR study is a parallel-group, superiority, randomized controlled trial (RCT), comprising 80 surgery patients. Half of the participants, randomly selected, perform a 16-week supervised exercise program, including both strength and aerobic training, starting immediately after the surgery (7–14 days). For each participant, all primary and secondary outcomes are measured at three different time points: (i) before the surgery, (ii) after the intervention (≈4 months), and (iii) 1 year after the surgery. Conclusion The EFIBAR study will provide new insights into the multidimensional benefits of exercise in adults with severe/extreme obesity following bariatric surgery. Trial Registration EFIBAR randomized controlled trial was prospectively registered at Clinicaltrials.gov (NCT03497546) on April 13, 2018. Graphical abstract

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Improvements in Heart Rate Variability in Women with Obesity: Short-term Effects of Sleeve Gastrectomy

Cited by 7 publications

References 59 publications

Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

Holter-Derived Autonomic Function, Arrhythmias and Carbohydrate Metabolism in Patients with Class III Obesity Treated with Laparoscopic Sleeve Gastrectomy

Role of the Autonomic Nervous System in Mechanism of Energy and Glucose Regulation Post Bariatric Surgery

Supervised Exercise Immediately After Bariatric Surgery: the Study Protocol of the EFIBAR Randomized Controlled Trial

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