Weight-loss surgery appears to benefit patients with heart failure, obesity
Click Here to Manage Email Alerts
Key takeaways:
- In patients with heart failure and obesity, weight-loss surgery conferred improved outcomes.
- Patients had reductions in BMI, HbA1c and reliance on diuretics at 24 months.
In a single-center cohort of patients with heart failure and obesity, weight-loss surgery led to improved clinical outcomes including reduced BMI and HbA1c and less reliance on diuretics, researchers reported.
“HF in the setting of comorbid obesity is strongly associated with negative effects on both symptom burden and exercise intolerance,” Michael Kachmar, DO, a metabolic and bariatric surgery fellow at Pennington Biomedical Research Center at Louisiana State University, and colleagues wrote in The American Journal of Cardiology. “Weight reduction in the setting of HF has been proposed to increase exercise tolerance and improve quality of life, with retrospective cohorts suggesting significant improvements in mortality. Despite this, the measurable effects of metabolic surgery on preexisting HF, namely diuretic use and emergency room utilization, remain unclear. Using diuretic dependency and emergency visit utilization as surrogates for clinical HF improvement, this study aims to describe the cardiac and metabolic outcomes of metabolic surgery in HF patients.”
The researchers retrospectively analyzed data from 63 patients (mean age, 53 years; 68% women; 54% with diabetes) who had prior HF and underwent weight-loss surgery (Roux-en-Y gastric bypass, 70%; sleeve gastrectomy, 27%; duodenal switch, 3%) at a single center from 2017 to 2023. They evaluated clinical outcomes at 24 months.
At 24 months, the mean change in BMI was –16 kg/m2, translating to a mean percentage of body weight lost of 29% (P < .001 for both), according to the researchers.
The cohort also had reductions in HbA1c (modeled reduction, –0.53; P < .001) and diuretic use (65%; P < .001), the researchers found.
The cohort also had numerically lower ED visits for cardiac complaints (P = .06) and IV diuresis (P = .07) at 12 months, Kachmar and colleagues wrote.
“The current study suggests that metabolic surgery in carefully selected patients with HF can significantly reduce oral diuretic dependency and improve metabolic parameters with a trend toward lower health care utilization,” the researchers wrote. “This is congruent with recent research indicating that metabolic surgery can mitigate the risk factors associated with HF and metabolic syndrome, thus enhancing patient outcomes postoperatively and likely improving quality of life in this increasingly prevalent population.”
Collapse
Click Here to Manage Email Alerts