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European Heart Journal Advance Access published online on June 4, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp211
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Effect of bariatric surgery on both functional and structural measures of premature atherosclerosis

Wolfgang Sturm1,{dagger}, Alexander Tschoner1,{dagger}, Julia Engl1, Susanne Kaser1, Markus Laimer1, Christian Ciardi1, Alexander Klaus2, Helmut Weiss2, Anton Sandhofer1, Josef R. Patsch1 and Christoph F. Ebenbichler1,*

1 Department of Internal Medicine I, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
2 Department of General and Transplant Surgery, Innsbruck Medical University, Innsbruck, Austria

Received 1 August 2008; revised 11 March 2009; accepted 4 May 2009 * Corresponding author. Tel: +43 512 504 28537, Fax: +43 512 504 28539, Email: christoph.ebenbichler{at}i-med.ac.at

Aims: To bridge the beneficial metabolic effects of pronounced weight loss on one side and the data on morbidity and mortality on the other side, we investigated the impact of profound weight loss on structural and functional markers of early atherosclerosis.

Methods and results: Thirty-seven obese adults were examined before and 18 months after bariatric surgery. Carotid intima–media thickness (CIMT), brachial flow-mediated dilation (FMD), nitroglycerine-mediated dilation, and abdominal fat distribution were assessed by high-resolution ultrasound. Surgery resulted in a body mass index decrease of 9.1 ± 4.9 kg/m2 with concomitant improvements in glucose and lipid metabolism. Carotid intima–media thickness diminished from 0.56 ± 0.09 to 0.53 ± 0.08 mm (n = 37; P = 0.004). Flow-mediated dilation improved from 5.81 ± 3.25 to 9.01 ± 2.93% (n = 25; P < 0.001). Both CIMT and FMD were associated with intra-abdominal fat diameter.

Conclusion: The present results demonstrate that bariatric surgery-induced diminution of visceral fat improves both functional and structural markers of early atherosclerosis, providing a link between the weight loss-associated improvements of traditional and non-traditional risk factors and the reduced long-term morbidity and mortality after bariatric surgery.

Key Words: Atherosclerosis • Obesity • Bariatric surgery • Weight loss • Intima media thickness • Flow mediated vasodilation

{dagger} The first two authors contributed equally to the study.


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