European Journal of Echocardiography Advance Access originally published online on April 4, 2008
European Journal of Echocardiography 2008 9(5):587-593; doi:10.1093/ejechocard/jen117
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Major weight loss prevents long-term left atrial enlargement in patients with morbid and extreme obesity
1 Division of Cardiovascular Diseases, Department of Medicine, 200 First St SW, Rochester 55905, MN, USA
2 Division of Gastroenterology Surgery, Department of Surgery, Rochester 55905, MN, USA
3 Division of Endocrinology, Department of Medicine, Mayo Clinic College of Medicine, Rochester 55905, MN, USA
Received 19 August 2007; accepted after revision 10 October 2007; online publish-ahead-of-print 4 April 2008.
* Corresponding author. Tel: +1 507 284 8087; fax: +1 507 266 3623. E-mail address: lopez{at}mayo.edu
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Abstract |
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Aims: To assess long-term changes in left atrial (LA) volume in patients with morbid obesity [body mass index (BMI) 
35 kg/m2 with co-morbidities] and extreme obesity (BMI 40 kg/m2), after surgically-induced weight loss (WL) after gastric bypass surgery.
Methods and results: We reviewed 57 patients who underwent gastric bypass surgery and had echocardiograms both before and after the operation. A control group was frequency-matched for BMI, sex, age, and for duration of follow-up. After a mean follow-up of 3.6 years, LA volume did not change significantly in patients who underwent bariatric surgery, but increased in the control group by 15 ± 28 ml (P < 0.0001), and 0.1 ± 0.2 ml (P < 0.0001) for height-indexed LA volume, with a difference between cases and controls that remained significant after adjusting for potential confounders (P = 0.01). In the study population as a whole, there was a positive correlation between change in body weight and change in LA volume (r = 0.22, P = 0.006) independent of clinical conditions associated with LA enlargement.
Conclusion: Change in body weight is associated with change in LA size independent of obesity-associated co-morbidities. Successful WL induced by bariatric surgery prevents the progressive increase in LA volume.
Keywords: Obesity; Bariatric surgery; Left atrial volume; Diastolic function
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