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Impact of Bariatric Surgery on Pulse Wave Velocity as a Measure of Arterial Stiffness: a Systematic Review and Meta-analysis

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Abstract

Purpose

Weight loss during post-bariatric surgery period has been linked to both reduced ASCVD mortality and overall mortality. Atherosclerosis causes arteries to lose their elasticity and become more stiff resulting in increased pulse wave velocity (PWV). It has been revealed that PWV favorably predicts subsequent ASCVDs. The goal of this systematic review and meta-analysis was to see how bariatric surgery affected PWV, an index of arterial stiffness.

Materials and Methods

A systematic literature search in four databases was performed. Also, Cochrane guidelines were reviewed to determine bias possibility in the related studies. Comprehensive Meta-Analysis (CMA) V2 software is used to conduct the meta-analysis. Studies were evaluated regarding heterogeneity in design, populations under investigation, and treatment duration using random-effects model and the generic inverse variance weighting approach. A random-effect meta-regression approach was used to investigate the association with the estimated effect size. Evaluation of funnel plot, Egger’s weighted regression, and Begg’s rank correlation tests were utilized to estimate the presence of publication bias in the meta-analysis.

Results

The results of meta-analysis on 13 trials including 1426 individuals demonstrated a remarkable decline of PWV after bariatric surgery (WMD: −0.652, 95% CI: −1.004, −0.301, p<0.001). The random-effects meta-regression revealed no evidence of significant correlation between the changes in PWV and initial BMI, BMI changes, or duration of follow-up.

Conclusion

The decrease of PWV might be utilized as an independent surrogate marker of improvement of ASCVD risk after bariatric surgery.

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References

  1. Kaul A et al. Impact of bariatric surgery on carotid intima-medial thickness and cardiovascular risk: results of a prospective study. Surgical Endoscopy. 2020:1–7.

  2. Alkharaiji M, Anyanwagu U, Donnelly R, et al. Effect of bariatric surgery on cardiovascular events and metabolic outcomes in obese patients with insulin-treated type 2 diabetes: a retrospective cohort study. Obesity surgery. 2019;29(10):3154–64.

    Article  Google Scholar 

  3. Laurent S, Cockcroft J, van Bortel L, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. European heart journal. 2006;27(21):2588–605.

    Article  Google Scholar 

  4. Safar M et al. Structural and functional modifications of peripheral large arteries in hypertensive patients. Journal of Clinical Hypertension. 1987;3(3):360–7.

    CAS  PubMed  Google Scholar 

  5. Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. JRSM Cardiovascular Disease. 2012;1(4):1–10.

    Article  Google Scholar 

  6. Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;55(13):1318–27.

    Article  Google Scholar 

  7. Yamashina A et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertension Research. 2002;25(3):359–64.

    Article  Google Scholar 

  8. Zieman SJ, Melenovsky V, Kass DA. Mechanisms, pathophysiology, and therapy of arterial stiffness. Arteriosclerosis, Thrombosis, and Vascular Biology. 2005;25(5):932–43.

    Article  CAS  Google Scholar 

  9. Mitchell GF, Hwang SJ, Vasan RS, et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation. 2010;121(4):505–11.

    Article  Google Scholar 

  10. Ben-Shlomo Y, Spears M, Boustred C, et al. Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects. Journal of the American College of Cardiology. 2014;63(7):636–46.

    Article  Google Scholar 

  11. Niiranen TJ et al. Relative contributions of arterial stiffness and hypertension to cardiovascular disease: the Framingham Heart Study. Journal of the American Heart Association. 2016;5(11):e004271.

    Article  Google Scholar 

  12. Sutton AJ et al. Methods for meta-analysis in medical research. Vol. 348. Chichester: Wiley; 2000.

  13. Higgins, J.P., Cochrane handbook for systematic reviews of interventions version 5.0. 1. The Cochrane Collaboration. http://www. cochrane-handbook. org, 2008.

  14. Wells, G.A., et al., The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2000, Oxford.

  15. Borenstein, M., et al., Comprehensive meta-analysis, version 2 Biostat. Englewood NJ, 2005.

  16. Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC medical research methodology. 2005;5(1):1–10.

    Article  Google Scholar 

  17. Banach M, Serban C, Ursoniu S, et al. Statin therapy and plasma coenzyme Q10 concentrations—a systematic review and meta-analysis of placebo-controlled trials. Pharmacological research. 2015;99:329–36.

    Article  CAS  Google Scholar 

  18. Duval S, Tweedie R. Trim and fill: a simple funnel-plot–based method of testing and adjusting for publication bias in meta-analysis. Biometrics. 2000;56(2):455–63.

    Article  CAS  Google Scholar 

  19. Tirado R et al. Arterial stiffness decreases after bariatric surgery in patients with morbid obesity. Diabetologia. 2012;55:S297.

    Google Scholar 

  20. Van Schinkel LD et al. Effects of bariatric surgery on pericardial ectopic fat depositions and cardiovascular function. Clinical Endocrinology. 2014;81(5):689–95.

    Article  Google Scholar 

  21. Gjevestad E, Hjelmesæth J, Sandbu R, et al. Effects of intensive lifestyle intervention and gastric bypass on aortic stiffness: a 1-year nonrandomized clinical study. Obesity. 2015;23(1):37–45.

    Article  Google Scholar 

  22. Domienik-Karlowicz J et al. The short-term effect of bariatric surgery on non-invasive markers of artery function in patients with metabolic syndrome. Diabetology & Metabolic Syndrome. 2015;7:76.

    Article  Google Scholar 

  23. Yu HY et al. Decreased visceral fat area correlates with improved arterial stiffness after Roux-en-Y gastric bypass in Chinese obese patients with type 2 diabetes mellitus: a 12-month follow-up. Surgery for Obesity and Related Diseases. 2016;12(3):550–5.

    Article  Google Scholar 

  24. Backdahl J et al. Long-term improvement in aortic pulse wave velocity after weight loss can be predicted by white adipose tissue factors. American Journal of Hypertension. 2018;31(4):450–7.

    Article  Google Scholar 

  25. Kolesnik E, Kolesnyk T, Duka R, et al. Changes of pulse wave velocity and the effectiveness of blood pressure control in patients with hypertension and morbid obesity after bariatric surgery. Journal of Hypertension. 2018;36:e280.

    Article  Google Scholar 

  26. Streese L, Königstein K, Goricki L, et al. Short- and long-term effects of bariatric surgery on vascular phenotype. Obesity Surgery. 2019;29(4):1301–8.

    Article  Google Scholar 

  27. Solini A, Seghieri M, Santini E, et al. Renal resistive index predicts post–bariatric surgery renal outcome in nondiabetic individuals with severe obesity. Obesity. 2019;27(1):68–74.

    Article  Google Scholar 

  28. Giudici A, Palombo C, Kozakova M, et al. Weight loss after bariatric surgery significantly improves carotid and cardiac function in apparently healthy people with morbid obesity. Obes Surg. 2020;30(10):3776–83.

    Article  Google Scholar 

  29. Frey S, Jacobi D, Pichelin M, et al. Improvement in arterial stiffness (pOpmetre (R)) after bariatric surgery. Results from a prospective study. Annales D Endocrinologie. 2020;81(1):44–50.

    Article  Google Scholar 

  30. Oliveras A, Goday A, Sans L, et al. Changes in central 24-h ambulatory blood pressure and hemodynamics 12 months after bariatric surgery: the BARIHTA Study. Obesity Surgery. 2020;30(1):195–205.

    Article  Google Scholar 

  31. Wang FCM et al. Increase in arterial stiffness measures after bariatric surgery. Atherosclerosis. 2021;320:19–23.

    Article  CAS  Google Scholar 

  32. Barinas-Mitchell E, Kuller LH, Sutton-Tyrrell K, et al. Effect of weight loss and nutritional intervention on arterial stiffness in type 2 diabetes. Diabetes care. 2006;29(10):2218–22.

    Article  CAS  Google Scholar 

  33. Borzì AM et al. Endothelial function in obese patients treated with bariatric surgery. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2020;13:247.

    Article  Google Scholar 

  34. Carmona-Maurici J, Cuello E, Ricart-Jané D, et al. Effect of bariatric surgery on inflammation and endothelial dysfunction as processes underlying subclinical atherosclerosis in morbid obesity. Surgery for Obesity and Related Diseases. 2020;16(12):1961–70.

    Article  Google Scholar 

  35. Carmona-Maurici J, Amigó N, Cuello E, et al. Bariatric surgery decreases oxidative stress and protein glycosylation in patients with morbid obesity. European Journal of Clinical Investigation. 2020;50(11):e13320.

    Article  CAS  Google Scholar 

  36. Van Bortel LM et al. Clinical applications of arterial stiffness, Task Force III: recommendations for user procedures. American Journal of Hypertension. 2002;15(5):445–52.

    Article  Google Scholar 

  37. Safar ME, Czernichow S, Blacher J. Obesity, arterial stiffness, and cardiovascular risk. Journal of the American Society of Nephrology. 2006;17(4 suppl 2):S109–11.

    Article  Google Scholar 

  38. Wildman R, MacKey R, Bostom A. Measures of obesity are associated with vascular stiffness in young and older adults. Journal of Vascular Surgery. 2004;39(4):920.

    Article  Google Scholar 

  39. Davies JI, Struthers AD. Pulse wave analysis and pulse wave velocity: a critical review of their strengths and weaknesses. Journal of hypertension. 2003;21(3):463–72.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

    Tannaz Jamialahmadi & Mona Alidadi

  2. Department of Internal Medicine, University Hospital Center Zagreb, University of Zagreb, Kišpatićeva 12, Zagreb, Croatia

    Željko Reiner

  3. Cleveland Clinic Abu Dhabi, PO Box 112412, Al Maryah Island, Abu Dhabi, United Arab Emirates

    Matthew Kroh

  4. Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico

    Luis E. Simental-Mendia

  5. Unit of Internal Medicine, Department of Medicine, University of Perugia, Perugia, Italy

    Matteo Pirro

  6. Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  7. School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  8. Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

    Amirhossein Sahebkar

  9. School of Medicine, The University of Western Australia, Perth, Australia

    Amirhossein Sahebkar

Authors
  1. Tannaz Jamialahmadi
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  2. Željko Reiner
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  3. Mona Alidadi
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  4. Matthew Kroh
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  5. Luis E. Simental-Mendia
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  6. Matteo Pirro
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  7. Amirhossein Sahebkar
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Corresponding author

Correspondence to Amirhossein Sahebkar.

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Key Points

• Weight loss post-bariatric surgery has been linked to reduced ASCVD mortality.

• It has been revealed that PWV favorably predicts subsequent ASCVDs.

• There is remarkable decline of PWV after bariatric surgery.

• There is no significant correlation between PWV and BMI change.

• There is no significant correlation between PWV and duration of follow-up.

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Jamialahmadi, T., Reiner, Ž., Alidadi, M. et al. Impact of Bariatric Surgery on Pulse Wave Velocity as a Measure of Arterial Stiffness: a Systematic Review and Meta-analysis. OBES SURG 31, 4461–4469 (2021). https://doi.org/10.1007/s11695-021-05611-7

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  • DOI: https://doi.org/10.1007/s11695-021-05611-7

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