The impact of bariatric surgery on coronary microvascular function assessed using automated quantitative perfusion CMR
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Authors
Crane, James D.
Joy, George
Knott, Kristopher D.
Augusto, João B.
Lau, Clement
Bhuva, Anish N.
Seraphim, Andreas
Evain, Timothée
Brown, Louise A.E.
Chowdhary, Amrit
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Issue Date
2024
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Article
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Abstract
BACKGROUND: Coronary microvascular function is impaired in patients with obesity, contributing to myocardial dysfunction and heart failure. Bariatric surgery decreases cardiovascular mortality and heart failure, but the mechanisms are unclear. OBJECTIVES: The authors studied the impact of bariatric surgery on coronary microvascular function in patients with obesity and its relationship with metabolic syndrome. METHODS: Fully automated quantitative perfusion cardiac magnetic resonance and metabolic markers were performed before and 6 months after bariatric surgery. RESULTS: Compared with age- and sex-matched healthy volunteers, 38 patients living with obesity had lower stress myocardial blood flow (MBF) (P = 0.001) and lower myocardial perfusion reserve (P < 0.001). A total of 27 participants underwent paired follow-up 6 months post-surgery. Metabolic abnormalities reduced significantly at follow-up including mean body mass index by 11 ± 3 kg/m CONCLUSIONS: 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.
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JACC: Cardiovascular Imaging
Volume
17
Issue
11