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The Impact of Bariatric Surgery on Cardiopulmonary Function: Analyzing VO2 Recovery Kinetics

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Abstract

Purpose

To assess cardiopulmonary capacity, autonomic heart function, and oxygen recovery kinetics during exercise testing before and after bariatric surgery.

Methods

This is a prospective cohort study. Symptom-limited cardiopulmonary exercise testing was performed with 24 patients, 1 week before and 4 months after bariatric surgery. The main variables were maximum oxygen uptake (VO2 max), the time elapsed until the appearance of the first ventilatory threshold (TLV1), and VO2 oxygen kinetics during recovery with a 50% reduction in peak oxygen uptake in the recovery period after exercise (50%VO2RP).

Results

The study demonstrated that the peak VO2\kg increased significantly after bariatric surgery. When analyzed without adjusting for weight, the peak VO2 paradoxically and significantly decreased after the surgical procedure (p = 0.007). The exercise time until the anaerobic threshold was longer after surgical procedure than before it (p = 0.001). Regarding post-exercise oxygen recovery kinetics, there was a faster reduction in the peak oxygen uptake after bariatric surgery than before the procedure (p < 0.001).

Conclusions

There was an obvious cardiac autonomic improvement after surgery. Despite the improvement in exercise tolerance, patients undergoing bariatric surgery had lower maximum oxygen consumption in the analysis not corrected for body weight. The mean VO2RP before bariatric surgery was 141 s and was 111 s after the surgical procedure (p < 0.001). These results suggest an improvement in the recovery kinetics of oxygen consumption, a novel index of cardiac reserve capacity, on patients undergoing bariatric surgery.

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References

  1. Wang Y, Beydoun MA. The obesity epidemic in the United States-gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev. 2007;29:6–28.

    Article  CAS  Google Scholar 

  2. Kachur S, Lavie CJ, de Schutter A, et al. Obesity and cardiovascular diseases. Minerva Med. 2017;108(3):212–28.

    PubMed  Google Scholar 

  3. Xia Y, Fu Y, Wang Y, et al. Prevalence and predictors of atherogenic serum lipoprotein dyslipidemia in women with obstructive sleep apnea. Sci Rep. 2017;30(7):41687.

    Article  Google Scholar 

  4. Beamish CJ, Olbers T, Kelly AS, et al. Cardiovascular effects of bariatric surgery. Nat Rev Cardiol. 2016;13(12):730–43.

    Article  CAS  Google Scholar 

  5. Ebong IA, Goff Jr DC, Rodriguez CJ, et al. The relationship between measures of obesity and incident heart failure: the multi-ethnic study of atherosclerosis. Obesity. 2013;21(9):1915–22.

    PubMed  Google Scholar 

  6. Ebong IA, Goff DC, Rodriguez CJ, et al. Mechanisms of heart failure in obesity. Obes Res Clin Pract. 2014;8(6):e540–e8.

    Article  Google Scholar 

  7. Snoek JA, van Berkel S, van Meeteren N, et al. Effect of aerobic training on heart rate recovery in patients with established heart disease; a systematic review. PLoS One. 2013;8(12):e83907.

    Article  Google Scholar 

  8. Kanoupakis E, Michaloudis D, Fraidakis O, et al. Left ventricular function and cardiopulmonary performance following surgical treatment of morbid obesity. Obes Surg. 2001;11(5):552–8.

    Article  CAS  Google Scholar 

  9. Bailey CS, Wooster LT, Buswell M, et al. Post-exercise oxygen uptake recovery delay: a novel index of impaired cardiac reserve capacity in heart failure. JACC Heart Fail. 2018;

  10. Fortin M, ves Turgeon PY, Nadreau E, et al. Prognostic value of oxygen kinetics during recovery from cardiopulmonary exercise testing in patients with chronic heart failure. CJC. 2015;31(10):1259–65.

    Google Scholar 

  11. Serés L, Lopez-Ayerbe J, Coll R, et al. Increased exercise capacity after surgically induced weight loss in morbid obesity. Obesity. 2006;14(2):273–9.

    Article  Google Scholar 

  12. Wilms B, Ernst B, Thurnheer M, et al. Differential changes in exercise performance after massive weight loss induced by bariatric surgery. Obes Surg. 2013;23(3):365–71.

    Article  Google Scholar 

  13. Skinner AC, Perrin EM, Moss LA, et al. Cardiometabolic risks and severity of obesity in children and young adults. N Engl J Med. 2015;373(14):1307–17.

    Article  Google Scholar 

  14. Gastrointestinal surgery for severe obesity. National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr. 1992;55(2 Suppl):487S–619S.

    Google Scholar 

  15. De Araújo CGS, Herdy AH, Stein R. Maximum oxygen consumption measurement: valuable biological marker in health and in sickness. Arq Bras Cardiol. 2013;100(4):e51–e3.

    PubMed  Google Scholar 

  16. Hergenroeder AL, Wert DM, Hile ES, et al. Association of body mass index with self-report and performance-based measures of balance and mobility. Phys Ther. 2011;91(8):1223–34.

    Article  Google Scholar 

  17. Wasmund SL, Yanowitz FG, Adams TD, et al. Improved heart rate recovery after marked weight loss induced by gastric bypass: two – year follow up in the Utah Obesity Study. 2012;8(1):84–90.

  18. Gow ML, van Doorn N, Broderick CR, et al. Sustained improvements in fitness and exercise tolerance in obese adolescents after a 12 week exercise intervention. Obes Res Clin Pract. 2015;

  19. Sharma VK, Subramanian SK, Arunachalam V. Evaluation of body composition and its association with cardio respiratory fitness in south Indian adolescents. Indian J Physiol Pharmacol. 2013;57(4):399–405.

    PubMed  Google Scholar 

  20. Hothi SS, Tan DK, Partridge G, et al. Is low VO2max/kg in obese heart failure patients indicative of cardiac dysfunction? Int J Cardiol. 2015;184:755–62.

    Article  CAS  Google Scholar 

  21. Mancini DM, Eisen H, Kussmaul W, et al. Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure. Circulation. 1991;83(3):778–86.

    Article  CAS  Google Scholar 

  22. Steele T, Cuthbertson DJ, Wilding JPH. Impact of bariatric surgery on physical functioning in obese adults. Obes Rev. 2015;16(3):248–58.

    Article  CAS  Google Scholar 

  23. Neunhaeuserer D, Gasperetti A, Savalla F, et al. Functional evaluation in obese patients before and after sleeve gastrectomy. Obes Surg. 2017;27:3230–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Clinical Medicine, Federal University of Pernambuco, Recife, PE, Brazil

    Maria Inês Remígio

  2. Federal University of Pernambuco School of Medicine, Rua Jorge de Albuquerque, 31 – apto. 1502 – Casa Forte, Recife, PE, 52061-100, Brazil

    Fernando Santa Cruz & Igor Nascimento

  3. Department of Surgery, Federal University of Pernambuco, Recife, PE, Brazil

    Álvaro Ferraz, Fernando de Moraes Neto & Josemberg Campos

  4. Department of Surgery, University of Pernambuco, Recife, PE, Brazil

    Maria Cecília Remígio

  5. Real Hospital Português de Beneficência de Pernambuco, Recife, PE, Brazil

    Giordano Parente

  6. Department of Physiotherapy, Federal University of Pernambuco, Recife, PE, Brazil

    Daniella Brandão & Armele de Fatima Dornelas de Andrade

Authors
  1. Maria Inês Remígio
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  2. Fernando Santa Cruz
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  3. Álvaro Ferraz
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  4. Maria Cecília Remígio
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  5. Giordano Parente
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  6. Igor Nascimento
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  7. Daniella Brandão
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  8. Armele de Fatima Dornelas de Andrade
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  9. Fernando de Moraes Neto
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  10. Josemberg Campos
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Corresponding author

Correspondence to Fernando Santa Cruz.

Ethics declarations

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This research project was approved by the Ethics Committee for Research involving human beings of the Federal University of Pernambuco’s Center of Health Sciences (N. 644.09) CAAE: 00723712.0.0000.5208. The authors declare that they have no conflicts of interests; informed consent was obtained from all individual participants included in the study.

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Remígio, M.I., Santa Cruz, F., Ferraz, Á. et al. The Impact of Bariatric Surgery on Cardiopulmonary Function: Analyzing VO2 Recovery Kinetics. OBES SURG 28, 4039–4044 (2018). https://doi.org/10.1007/s11695-018-3469-4

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  • DOI: https://doi.org/10.1007/s11695-018-3469-4

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