Normalization of Cardiac Function After Bariatric Surgery Is Related to Autonomic Function and Vitamin D
Obes Surg . 2022 Nov 5. doi: 10.1007/s11695-022-06336-x
Sanne M Snelder 1 , Yaar Aga 1 , Lotte E de Groot-de Laat 2 , L Ulas Biter 3 , Manuel Castro Cabezas 4 5 , Nadine Pouw 6 , Erwin Birnie 7 , Bianca Boxma-de Klerk 7 , René A Klaassen 8 , Felix Zijlstra 9 , Bas M van Dalen 10 11
Purpose: Subclinical cardiac dysfunction is common in patients with obesity. Bariatric surgery is associated with normalization of subclinical cardiac function in 50% of the patients with obesity. The aim of this study was to identify predictors for a lack of improvement of subclinical cardiac dysfunction 1-year post-bariatric surgery.
Methods: Patients who were referred for bariatric surgery were enrolled in a longitudinal study. Inclusion criteria were age 35-65 years and BMI ≥ 35 kg/m2. Patients with a suspicion of or known cardiovascular disease were excluded. Conventional and advanced echocardiography, Holter monitoring, and blood tests were performed pre- and 1-year post-bariatric surgery. Subclinical cardiac dysfunction was defined as either a reduced left ventricular ejection fraction, decreased global longitudinal strain (GLS), diastolic dysfunction, arrhythmia, or an increased BNP or hs Troponin I.
Results: A total of 99 patients were included of whom 59 patients had cardiac dysfunction at baseline. Seventy-two patients completed the 1-year follow-up after bariatric surgery. There was a significant reduction in weight and cardiovascular risk factors. Parameters of cardiac function, such as GLS, improved. However, in 20 patients cardiac dysfunction persisted. Multivariate analysis identified a decreased heart rate variability (which is a measure of autonomic function), and a decreased vitamin D pre-surgery as predictors for subclinical cardiac dysfunction after bariatric surgery.
Conclusion: Although there was an overall improvement of cardiac function 1-year post-bariatric surgery, autonomic dysfunction and a decreased vitamin D pre-bariatric surgery were predictors for a lack of improvement of subclinical cardiac dysfunction.
- Hypothesis - Dysfunction of Autonomic Nervous System is associated with low vitamin D – April 2017
- Salmon intervention (vitamin D and Omega-3) improved heart rate variability and reduced anxiety – Nov 2014
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- Impact of Vitamin D supplementation on Heart Rate Variability in Vitamin D deficient Asthma COPD Overlap Syndrome patients: A Randomized Controlled Trial - Dec 2020 FREE PDF
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- Sarcopenia and Cardiac Dysfunction - May 2020 DOI: https://doi.org/10.1097/CRD.0000000000000285
- Association between Micronutrients and Heart Rate Variability: A Review of Human Studies - May 2020, https://doi.org/10.1093/advances/nmz136 FREE PDF
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