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Cardiovascular Changes After Gastric Bypass Surgery: Involvement of Increased Secretions of Glucagon-Like Peptide-1 and Brain Natriuretic Peptide

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Abstract

Background

Obesity induces cardiovascular alterations, including cardiac hypertrophy, impaired relaxation, and heart rate variability (HRV), which are associated with increased mortality. Gastric bypass surgery (GBP) reduces cardiovascular mortality, but the mechanisms involved are not clearly established. To date, the implication of postsurgical hormonal changes has not been tested. Our aim was to study the relationships between the evolution of cardiovascular functions after GBP and changes in metabolic and hormonal parameters, including glucagon-like peptide-1 (GLP-1) and brain natriuretic peptide (N-terminal pro-brain natriuretic peptide (NT-proBNP)).

Methods

Echocardiographic parameters, 24-h rhythmic Holter recording, plasma concentrations of GLP-1 before and after a test meal, and fasting NT-proBNP were assessed in 34 patients (M/F 2/32, age 36 ± 11 years, BMI 46 ± 6 kg/m2), before and 1 year after GBP.

Results

After GBP, excess weight loss was 79 ± 20 %. Blood pressure (BP), heart rate, and left ventricular mass decreased, while HRV and diastolic function (E/A ratio) improved. Plasma concentrations of NT-proBNP and postprandial (PP) GLP-1 increased. Changes in cardiovascular parameters were related to BMI and insulin sensitivity. Furthermore, the decrease in BP was independently associated with the increase of PP GLP-1 level and HRV was positively associated with NT-proBNP concentration after surgery.

Conclusions

The increase in endogenous GLP-1 observed after GBP was associated with decreased BP but not with improvement of other cardiovascular parameters, whereas the increase in NT-proBNP, within the physiological range, was associated with improved HRV.

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Conflict of Interest

This work received financial support from Assistance Publique des Hôpitaux de Paris. The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Explorations Fonctionnelles, Centre de l’obésité, Hôpital Louis Mourier, Groupe Hospitalier HUPNVS (AP-HP), 178 rue des Renouillers, 92700, Colombes, France

    Maria-Pia Gandolfini, Muriel Coupaye & Séverine Ledoux

  2. Service de Cardiologie, Hôpital Max Fourestier, 92000, Nanterre, France

    Maria-Pia Gandolfini

  3. Université Paris Diderot, Paris, France

    Muriel Coupaye & Séverine Ledoux

  4. Biochimie Endocrinienne et Oncologique, Groupe Hospitalier Pitié Salpêtrière (AP-HP), 75013, Paris, France

    Elodie Bouaziz & Jean-Marc Lacorte

  5. Université Pierre et Marie Curie, Paris, France

    Elodie Bouaziz & Jean-Marc Lacorte

  6. Service de Biochimie, Hôpital Bichat, Groupe Hospitalier HUPNVS (AP-HP), Paris, France

    Monique Dehoux

  7. Département d’Epidémiologie et Recherche Clinique, Hôpital Louis Mourier, Groupe Hospitalier HUPNVS (AP-HP), 92700, Colombes, France

    David Hajage

Authors
  1. Maria-Pia Gandolfini
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  2. Muriel Coupaye
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  3. Elodie Bouaziz
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  4. Monique Dehoux
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  5. David Hajage
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  6. Jean-Marc Lacorte
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  7. Séverine Ledoux
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Correspondence to Séverine Ledoux.

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Gandolfini, MP., Coupaye, M., Bouaziz, E. et al. Cardiovascular Changes After Gastric Bypass Surgery: Involvement of Increased Secretions of Glucagon-Like Peptide-1 and Brain Natriuretic Peptide. OBES SURG 25, 1933–1939 (2015). https://doi.org/10.1007/s11695-015-1643-5

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  • DOI: https://doi.org/10.1007/s11695-015-1643-5

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