Improvement of Cardiac Function After Roux-en-Y Gastric Bypass in Morbidly Obese Patients Without Cardiac History Measur
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ORIGINAL CONTRIBUTIONS
Improvement of Cardiac Function After Roux-en-Y Gastric Bypass in Morbidly Obese Patients Without Cardiac History Measured by Cardiac MRI Dennis de Witte 1,2 & Leontine H. Wijngaarden 3 & Vera A. A. van Houten 3,4 & Marinus A. van den Dorpel 5 & Tobias A. Bruning 6 & Erwin van der Harst 3 & René A. Klaassen 3 & Roelf A. Niezen 1
# The Author(s) 2020
Abstract Purpose Metabolic syndrome in patients with morbid obesity causes a higher cardiovascular morbidity, eventually leading to left ventricular hypertrophy and decreased left ventricular ejection fraction (LVEF). Roux-en-Y gastric bypass (RYGB) is considered the gold standard modality for treatment of morbid obesity and might even lead to improved cardiac function. Our objective is to investigate whether cardiac function in patients with morbid obesity improves after RYGB. Materials and Methods In this single center pilot study, 15 patients with an uneventful cardiac history who underwent RYGB were included from May 2015 to March 2016. Cardiac function was measured by cardiac magnetic resonance imaging (CMRI), performed preoperatively and 3, 6, and 12 months postoperative. LVEF and myocardial mass and cardiac output were measured. Results A total of 13 patients without decreased LVEF preoperative completed follow-up (mean age 37, 48.0 ± 8.8). There was a significant decrease of cardiac output 12 months postoperative (8.3 ± 1.8 preoperative vs. 6.8 ± 1.8 after 12 months, P = 0.001). Average myocardial mass declined by 15.2% (P < 0.001). After correction for body surface area (BSA), this appeared to be nonsignificant (P = 0.36). There was a significant improvement of LVEF/BSA at 6 and 12 months postoperative (26.2 ± 4.1 preoperative vs. 28.4 ± 3.4 and 29.2 ± 3.6 respectively, both P = 0.002). Additionally, there was a significant improvement of stroke volume/BSA 12 months after surgery (45.8 ± 8.0 vs. 51.9 ± 10.7, P = 0.033). Conclusion RYGB in patients with morbid obesity with uneventful history of cardiac disease leads to improvement of cardiac function. Keywords Obesity . Bariatric surgery . Roux-en-Y gastric bypass . Cardiac magnetic resonance imaging . Left ventricular ejection fraction . Left ventricular mass
* Dennis de Witte [email protected]
Roelf A. Niezen [email protected]
Leontine H. Wijngaarden [email protected]
1
Department of Radiology, Maasstad Hospital, Rotterdam, the Netherlands
Vera A. A. van Houten [email protected]
2
Department of Radiology, Erasmus Medical Centre, Rotterdam, the Netherlands
Marinus A. van den Dorpel [email protected]
3
Department of Surgery, Maasstad Hospital, Rotterdam, the Netherlands
Tobias A. Bruning [email protected]
4
Department of Surgery, Deventer Hospital, Deventer, the Netherlands
Erwin van der Harst [email protected]
5
Department of Internal Medicine, Maasstad Hospital, Rotterdam, the Netherlands
René A. Klaassen [email protected]
6
Department of Cardiology, Maasstad Hospital, Rotterdam, the
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