Cardiometabolic & kidneyCohort study
The Impact of Bariatric Surgery on Coronary Microvascular Function Assessed Using Automated Quantitative Perfusion CMR
- Prospective cohort study
- paired before-after
- healthy volunteer comparison
Authors' conclusion
Coronary microvascular function is impaired in patients with obesity, but can be improved significantly with bariatric surgery. Improvements in microvascular function are associated with improvements in insulin resistance but are attenuated in those with preoperative type 2 diabetes mellitus.
Study context
- Population
- Patients with obesity undergoing bariatric surgery27 with paired follow-up
- Exposure
- Before vs 6 months after bariatric surgery; patients with obesity vs age- and sex-matched healthy volunteers
- Obesityn = 38
- Outcome
- Coronary microvascular function (stress MBF, myocardial perfusion reserve) by automated quantitative perfusion CMR
- Follow-up
- 6 months after bariatric surgery
Main finding
As reported in the abstract
Stress myocardial blood flow (MBF) increase
0.28 mL/g/min (Q1-Q3: −0.02 to 0.75 mL/g/min; P = 0.003)
Myocardial perfusion reserve increase
0.13 (Q1-Q3: −0.25 to 1.10; P = 0.036)
Observational data: associations, not effects.
Further findings
Baseline: obesity vs healthy volunteers
- Lower stress MBF in obesity
- P = 0.001
- Lower myocardial perfusion reserve in obesity
- P < 0.001
Metabolic changes after surgery · 6 months post-surgery
- Mean BMI reduction
- 11 ± 3 kg/m² (P < 0.001)
- Glycated hemoglobin reduction
- 9 mmol/mol (Q1-Q3: 4-19 mmol/mol; P < 0.001)
- Fasting insulin reduction
- 142 ± 131 pmol/L (P < 0.001)
- Hepatic fat fraction reduction
- 5.6% (Q1-Q3: 2.6%-15.0%; P < 0.001)
Stress MBF increase, by preoperative T2DM (subgroup) · 6 months post-surgery
- Increase lower with preoperative T2DM vs without
- 0.1 mL/g/min [Q1-Q3: −0.09 to 0.46 mL/g/min] vs 0.75 mL/g/min [Q1-Q3: 0.31-1.25 mL/g/min]; P = 0.002
Stress MBF improvement vs fasting insulin reduction
- Association (beta)
- −0.45 [95% CI: −0.05 to 0.90]; P = 0.03
Original publication
Summarised from the published abstract; every number is checked against it