A pioneering study has found that weight loss surgery improved the blood supply to the heart for people living with obesity.
Weight loss surgery may reduce the risk of developing heart failure for people living with obesity by improving blood flow through their heart muscle, according to a new study from King's and University College London (UCL).
People living with obesity are at increased risk of heart failure. It's thought that this may be due, in part, to reduced blood flow through the small vessels in their hearts. The new study, published in the Journal of the American College of Cardiology (JACC) Cardiovascular Imaging, suggests that these harmful effects of obesity may be at least partly reversible.
Heart scans from 27 patients showed that, six months after bariatric surgery, blood flow through these small blood vessels had increased, alongside improvements in other well-known risk factors for developing heart disease.
Co-led by Professor Barbara McGowan of King's and Professor Charlotte Manisty of UCL, with support from King's' Professor Francesco Rubino, the researchers scanned patients' hearts before, and six months after, they underwent bariatric surgery. The team used quantitative perfusion magnetic resonance imaging to measure blood flow through the smallest vessels in the heart muscle.
Before their surgery, patients had a median body mass index (BMI) of 44kg/m2. Compared to volunteers of the same age and sex with an average BMI of 25, patients had thicker heart walls (a sign that the heart is having to work harder to pump blood) and lower blood flow through their heart muscle. Six months after their surgery, patients had lost an average of 29 kg, and 13 of the 17 patients with type 2 diabetes before surgery were in remission at follow up.
Previous research has suggested that weight loss surgery can reduce the risk of developing or dying from cardiovascular disease in people living with obesity. Our work provides a new, additional explanation for the benefits of this intervention."
Professor Charlotte Manisty, Professor of Cardiology at University College London
When the team repeated the heart scans, they found that blood flow through patients' hearts had increased. In addition, levels of triglyceride fats in patients' blood had decreased, while their levels of HDL ('good') cholesterol increased. Patients also had less fat around their livers (a marker of the levels of fat stored around the abdominal organs) and lower blood pressure than before their surgery.
This research yet again underlines the connection between obesity and the risk of developing heart disease. While not everyone will need surgery or medication to lose weight, it's important that weight loss treatment and support are available to everyone who needs it."
Dr Sonya Babu-Narayan, Associate Medical Director at the British Heart Foundation and consultant cardiologist
These results highlight another potential benefit of bariatric surgery in managing heart failure in people living with obesity. Future research will look at whether other weight loss treatments, such as medications, also utilise this mechanism.
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Consultant Endocrinologist
Chair of Metabolic and Bariatric Surgery
