학술논문

Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry
Document Type
article
Source
Frontiers in Endocrinology, Vol 14 (2023)
Subject
obesity
epicardiac adipose tissue
weight loss
bariatric surgery
cardiac remodelling
cardiac geometry
Diseases of the endocrine glands. Clinical endocrinology
RC648-665
Language
English
ISSN
1664-2392
Abstract
IntroductionObesity affects cardiac geometry, causing both eccentric (due to increased cardiac output) and concentric (due to insulin resistance) remodelling. Following bariatric surgery, reversal of both processes should occur. Furthermore, epicardial adipose tissue loss following bariatric surgery may reduce pericardial restraint, allowing further chamber expansion. We investigated these changes in a serial imaging study of adipose depots and cardiac geometry following bariatric surgery.Methods62 patients underwent cardiac magnetic resonance (CMR) before and after bariatric surgery, including 36 with short-term (median 212 days), 37 medium-term (median 428 days) and 32 long-term (median 1030 days) follow-up. CMR was used to assess cardiac geometry (left atrial volume (LAV) and left ventricular end-diastolic volume (LVEDV)), LV mass (LVM) and LV eccentricity index (LVei – a marker of pericardial restraint). Abdominal visceral (VAT) and epicardial (EAT) adipose tissue were also measured.ResultsPatients on average had lost 21kg (38.9% excess weight loss, EWL) at 212 days and 36kg (64.7% EWL) at 1030 days following bariatric surgery. Most VAT and EAT loss (43% and 14%, p