Weight Loss After Bariatric Surgery Reverses Heart Abnormalities in Obese Teens

Monday, January 01, 0001

Two years after teens undergo bariatric surgery for morbid obesity, abnormalities in their hearts that put them at increased risk for heart attacks in adulthood were dramatically reduced, thanks to significant weight loss.

A Cincinnati Children’s Hospital Medical Center study shows that the size of the left ventricle in morbidly obese teens dramatically decreases within six months of weight loss and maintains that decrease two years post-surgery. In addition, diastolic dysfunction -- the way the left ventricle fills with blood when the heart is relaxing -- remains significantly improved.

The study was presented on Tuesday, Nov. 17, at the annual meeting of the American Heart Association in Orlando. Holly Ippisch, MD, a pediatric cardiologist at the Cincinnati Children’s Heart Institute and the study’s lead author, also will discuss her study at 2 p.m. that day as part of a news conference in the news media center at the AHA meeting.

“Left ventricular hypertrophy – an increase in the mass and wall thickness of the left ventricle – and diastolic dysfunction are associated with an increased risk of cardiac events, such as heart attacks, in adulthood,” says Holly Ippisch, MD, “Many extremely obese teens have a form of hypertrophy thought to carry the highest risk in adults. The exciting news is that after significant weight loss following surgery, it significantly improved.”

The study is among the latest in a continuum of research conducted at the Heart Institute focusing on childhood obesity as a risk factor for heart disease in later life.

Dr. Ippisch studied 83 adolescents who had undergone an echocardiogram prior to bariatric surgery. Of those teens being followed, 55 had echoes six months after surgery, 41 at one year, and 21 at two years after surgery. Changes in left ventricular mass and diastolic function improved significantly within six months and persisted 18 months later. The prevalence of teens with abnormal left ventricles decreased from 49 percent preoperatively to 24 percent two years after surgery.

“This is encouraging and suggests that early weight loss produces lasting improvements in cardiac risk factors,” says Dr. Ippisch. “Long-term follow-up studies are needed to determine whether these findings translate into reduction in cardiovascular disease during adulthood.”

Gastric bypass surgery at Cincinnati Children’s is reserved as a method of last resort for weight loss in extremely obese teens. It complements the Center for Better Health and Nutrition, an initiative of the Heart Institute.

The study was funded by grants from the National Heart, Lung, and Blood Institute, and the National Institute of Diabetes and Digestive and Kidney Diseases – both agencies of the National Institutes of Health.

About Cincinnati Children’s

Cincinnati Children’s Hospital Medical Center is one of 10 children’s hospitals in the United States to make the Honor Roll in U.S. News and World Reports 2009-10 America’s Best Children’s Hospitals issue. It is #1 ranked for digestive disorders and is also highly ranked for its expertise in respiratory diseases, cancer, neonatal care, heart care, neurosurgery, diabetes, orthopedics, kidney disorders and urology. One of the three largest children’s hospitals in the U.S., Cincinnati Children’s is affiliated with the University of Cincinnati College of Medicine and is one of the top two recipients of pediatric research grants from the National Institutes of Health.

President Barack Obama in June 2009 cited Cincinnati Children’s as an “island of excellence” in health care. For its achievements in transforming health care, Cincinnati Children’s is one of six U.S. hospitals since 2002 to be awarded the American Hospital Association-McKesson Quest for Quality Prize for leadership and innovation in quality, safety and commitment to patient care. The hospital is a national and international referral center for complex cases. Additional information can be found at www.cincinnatichildrens.org.