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Rapid Change in Afterload After Gastric By‐Pass Surgery
Author(s) -
DeVallance Evan,
Lee Kyuwan,
Grogg Kristen,
LeMaster Kent,
Brader Alan,
Tabone Lawrence,
Rosati Kristen,
Quinlin Robert,
Frisbee Jefferson,
Chantler Paul
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.952.5
Subject(s) - afterload , medicine , arterial stiffness , cardiology , blood pressure , cardiac function curve , risk factor , waist , ejection fraction , weight loss , cardiac output , cardiac surgery , preload , obesity , hemodynamics , heart failure
Obesity is associated with increased arterial dysfunction, an independent risk factor linking obesity to an elevated risk of cardiovascular (CV) mortality. Interventions are needed to alleviate the burden of obesity on the CV system. Gastric bypass surgery (GBS) is an intervention associated with rapid weight loss and a reduction in future CV events. We aim to show the immediate effects of GBS on CV function assessed by pulse wave analysis on 12 GBS patients. As expected weight decreased (pre: 132±6 to post: 125±5 Kg, p<0.01) 1‐week post GBS this coincided with a reduction in waist circumference (pre: 122±5 to post: 112±3 cm, p<0.05). Central systolic blood pressure (pre: 112±4 to post: 105±2 mmHg, p=0.08), augmentation index (pre:16±3 to post:8±3 ,p=0.06), an indirect measure of stiffness, and central augmentation pressure (pre: 5±1 to post: 3±1 mmHg, p=0.06) tended to decrease 1‐week post GBS. These changes were independent of a change in brachial BP. These measures suggest GBS and postoperative care reduce arterial load leading to a decrease in cardiac afterload. The reduction in afterload allows for shorter ejection duration (pre: 326±8 post: 302±11 ms, p<0.05) and higher contractile rates (dP/dt pre: 672±54 post: 737±46, p<0.01) leading to a decrease of the oxygen demand in the myocardium (PTIs pre: 2346±120 post: 2194±107 area/min, p<0.05) and more efficient cardiac work. GBS quickly improves central arterial function alleviating some of the cardiac workload.