- Oral presentation
- Open Access
Disproportionate abdominal visceral fat mass reduction and complete reversal of cardiovascular remodelling accompany Roux-en-Y gastric bypass but not gastric banding - benefits beyond simply weight loss
© Rayner et al. 2016
- Published: 27 January 2016
- Gastric Banding
- Aortic Stiffness
- Aortic Distensibility
- Left Ventricular Geometry
- Normal Weight Control
It is emerging that distribution of body fat, and in particular visceral fat (VFAT) is more important in determining cardiovascular risk than total body fat percentage. Roux-en-Y gastric bypass (RYGB) may preferentially reduce visceral fat, thus providing a mechanism to study the impact of visceral fat on cardiovascular function. We sought to determine 1) whether visceral fat is related to adverse left ventricular (LV) remodelling and reduced aortic distensibility, and 2) whether RYGB, by preferentially targeting visceral fat, results in greater improvements in LV geometry and vascular function than gastric banding.
159 subjects (body mass index (BMI) 18.5-59.2) without cardiovascular risk factors, underwent dual-energy X-Ray absorptiometry for fat distribution, MRI assessment (1.5T) for visceral fat and cardiac MR for LV geometry (mass and mass:volume ratio (LVMVR)). Aortic distensibility was assessed at 3 levels; the ascending and proximal descending aorta at pulmonary artery level and the abdominal aorta. 26 subjects underwent repeat testing 2.5 years following bariatric surgery (14 RYGB and 12 gastric banding).
After matching for BMI and total fat mass, patients were separated into two groups according to visceral fat. The high visceral fat group had greater concentric LV remodelling (LVMVR 0.93 ± 0.02 vs 0.77 ± 0.02; p < 0.001) and reduced aortic distensibility (by 18-27%; p < 0.01), suggesting that visceral fat rather than total fat mass is related to adverse cardiovascular remodelling.
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