Bariatric Surgery and the Cardiovascular System
Research type
Research Study
Full title
Comparing the Effects of Bariatric Surgery on the Cardiovascular System
IRAS ID
218081
Contact name
Prof Oliver Rider
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Research Summary:
Obesity causes several adverse changes in the heart (which enlarges) and blood vessels (which stiffen). Although dieting has been shown to improve these changes, without surgical intervention reversal of obesity is uncommon and in the majority of cases rebound weight gain occurs. As a result weight loss surgery is increasingly recognised as the only successful means by which to control weight in the long term.
Three forms of weight loss surgery are currently performed, gastric bypass, gastric banding and sleeve gastrectomy. It is unknown whether all of these are equivalent in improving the health of the heart and blood vessels, but there is some suggestion that bypass surgery may confer the greatest benefit by reducing the amount of visceral (body fat that is stored within the abdominal cavity) or “bad” fat.
This is an observational study that will recruit patients about to receive weight loss surgery as part of their clinical care and follow them for 2 years after surgery. Participants undergo cardiac and body composition assessment using a combination of magnetic resonance imaging (MRI) with gadolinium contrast, magnetic resonance spectroscopy, echocardiography and computed tomography (CT) at the University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR).
This study will improve our understanding of the effects of weight loss surgery on the cardiovascular system and compare the cardiovascular benefits achieved with these three forms of surgery. This study should establish the most effective surgical treatment for obesity by identifying which type of surgery has the potential to improve outcomes and reduce healthcare costs in the long term.
This work is funded by the British Heart Foundation and conducted by the Radcliffe Department of Medicine Division of Cardiovascular Medicine, University of Oxford.Summary of Results:
Being very overweight can change the shape and size of the heart in two ways: the heart stretches bigger to pump more blood, and the heart walls get thicker because of problems with how the body uses sugar. After weight loss surgery, both of these changes should start to reverse. Losing fat around the heart might also make it easier for the heart to expand. In this study, people had heart scans before and after surgery to see how their hearts changed over time. At first, they lost a lot of weight, and most of the fat inside the belly and around the heart was reduced early on. This caused the heart to become smaller, with its chambers shrinking and its muscle mass decreasing. Over time, the heart muscle kept getting thinner, but the heart chambers returned to their original size. Losing fat around the heart also made it easier for the heart to move and expand. This study shows that weight loss surgery helps the heart in different ways, first by making it smaller and then by allowing it to return to a healthier shape and function.
REC name
South Central - Oxford A Research Ethics Committee
REC reference
17/SC/0167
Date of REC Opinion
17 May 2017
REC opinion
Further Information Favourable Opinion