Effect of bariatric surgery on peripheral flow-mediated dilation and coronary microvascular function

R. Nerla, P. Tarzia, A. Sestito, A. Di Monaco, F. Infusino, D. Matera, F. Greco, R. M. Tacchino, G. A. Lanza, F. Crea

Research output: Contribution to journalArticlepeer-review

Abstract

Background and aims: To assess the effects of bariatric surgery (BS) on peripheral endothelial function and on coronary microvascular dilator function. Methods and results: We studied 50 morbidly obese patients (age 38 ± 9, 13 M) who underwent BS and 20 comparable obese controls (age 41 ± 11, 6 M) without any evidence of cardiovascular disease. Peripheral vascular dilator function was assessed by brachial artery diameter changes in response to post-ischemic forearm hyperaemia (flow-mediated dilation, FMD). Coronary microvascular function was assessed by measuring coronary blood flow (CBF) velocity response to i.v. adenosine and to cold pressor test (CPT) in the left anterior descending coronary artery by transthoracic Doppler echocardiography. The tests were performed at baseline and at 3-month follow-up. At baseline, FMD and CBF response to adenosine and CPT were similar in the 2 groups. Compared to baseline, FMD at follow-up improved significantly in BS patients (5.9 ± 2.7% to 8.8 ± 2.4%, p <0.01), but not in controls (6.3 ± 3.2% vs. 6.4 ± 3.1%, p = 0.41). Similarly, a significant improvement of CBF response to adenosine (1.63 ± 0.47 to 2.45 ± 0.57, p <0.01) and to CPT (1.43 ± 0.26 to 2.13 ± 0.55, p <0.01) was observed in BS patients but not in controls (1.55 ± 0.38 vs. 1.53 ± 0.37, p = 0.85; and 1.37 ± 0.26 vs. 1.34 ± 0.21, p = 0.48, respectively). The favourable vascular effects of BS were similar independently of the presence and changes of other known cardiovascular risk factors and of basal values and changes of serum C-reactive protein levels. Conclusions: Our data show that, in morbidly obese patients, together with peripheral endothelial function, BS also improves coronary microvascular function. These effects suggest global improvement of vascular function which can contribute significantly to the reduction of cardiovascular risk by BS reported in previous studies.

Original languageEnglish
Pages (from-to)626-634
Number of pages9
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume22
Issue number8
DOIs
Publication statusPublished - Aug 2012

Keywords

  • Bariatric surgery
  • Coronary microvascular function
  • Flow-mediated dilation

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Endocrinology, Diabetes and Metabolism
  • Cardiology and Cardiovascular Medicine

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