Tarzia Pierpaolo, Lanza Gaetano A, Sestito Alfonso, Villano Angelo, Russo Giulio, Figliozzi Stefano, Lamendola Priscilla, De Vita Antonio, Crea Filippo
Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
Institute of Cardiology, Università Cattolica del Sacro Cuore, Roma, Italy.
Obes Res Clin Pract. 2017 Jan-Feb;11(1):114-117. doi: 10.1016/j.orcp.2016.12.005. Epub 2017 Jan 2.
We previously demonstrated that bariatric surgery (BS) leads to a short-term significant improvement of endothelial function and coronary microvascular function. In this study we assessed whether BS maintains its beneficial effect at long-term follow up.
We studied 19 morbidly obese patients (age 43±9years, 12 women) without any evidence of cardiovascular disease who underwent BS. Patients were studied before BS, at 3 months and at 4.0±1.5years follow up.
Peripheral vascular function was assessed by flow-mediated dilation (FMD) and nitrate-mediated dilation (NMD), i.e., brachial artery diameter changes in response to post-ischemic forearm hyperhaemia and to nitroglycerin administration, respectively. Coronary microvascular function was assessed by measuring coronary blood flow (CBF) response to intravenous adenosine and to cold pressor test (CPT) in the left anterior descending coronary artery.
Together with improvement of anthropometric and metabolic profile, at long-term follow-up patients showed a significant improvement of FMD (6.43±2.88 vs. 8.21±1.73%, p=0.018), and CBF response to both adenosine (1.73±0.48 vs. 2.58±0.54; p<0.01) and CPT (1.43±0.30 vs. 2.23±0.48; p<0.01), compared to basal values. No differences in vascular end-points were shown at 3-month and 4-year follow-up after BS.
Our data show that, in morbidly obese patients, BS exerts beneficial and long lasting effects on peripheral endothelial function and on coronary microvascular dilator function.
我们之前证明，减肥手术（BS）可使内皮功能和冠状动脉微血管功能在短期内得到显著改善。在本研究中，我们评估了减肥手术在长期随访中是否仍保持其有益作用。
我们研究了19例无任何心血管疾病证据的病态肥胖患者（年龄43±9岁，12名女性），这些患者接受了减肥手术。在减肥手术前、术后3个月以及4.0±1.5年的随访时对患者进行研究。
通过血流介导的血管舒张（FMD）和硝酸盐介导的血管舒张（NMD）评估外周血管功能，即分别通过缺血后前臂充血和给予硝酸甘油后肱动脉直径的变化来评估。通过测量左前降支冠状动脉对静脉注射腺苷和冷加压试验（CPT）的冠状动脉血流（CBF）反应来评估冠状动脉微血管功能。
与人体测量和代谢指标的改善一致，在长期随访中，与基础值相比，患者的FMD有显著改善（6.43±2.88%对8.21±1.73%，p = 0.018），并且对腺苷（1.73±0.48对2.58±0.54；p<0.01）和CPT（1.43±0.30对2.23±0.48；p<0.01）的CBF反应均有显著改善。减肥手术后3个月和4年随访时，血管终点指标无差异。
我们的数据表明，在病态肥胖患者中，减肥手术对外周内皮功能和冠状动脉微血管舒张功能具有有益且持久的影响。
