A new study led by researchers from University College London (UCL) suggests that weight loss surgery may significantly reduce the risk of heart failure in people living with obesity by enhancing blood flow through the heart muscle.
This study sheds light on how the harmful cardiovascular effects of obesity could be partially reversible through surgical intervention.
People with obesity face a heightened risk of developing heart failure, a condition where the heart struggles to pump blood effectively. One contributing factor to this increased risk is thought to be reduced blood flow through the small vessels in the heart.
The study, published in JACC: Cardiovascular Imaging by researchers from UCL and King’s College London, indicates that these adverse effects of obesity can be improved, at least in part, by bariatric surgery.
In the study, heart scans of 27 patients were analyzed before and six months after they underwent bariatric surgery—a type of surgery aimed at significant weight loss.
The scans revealed that blood flow through the small vessels in the heart had improved post-surgery, along with improvements in other cardiovascular risk factors.
Professor Charlotte Manisty from the UCL Institute of Cardiovascular Science, who led the study, noted that while previous research has shown that weight loss surgery can reduce the risk of cardiovascular disease and mortality in obese individuals, this new study provides additional evidence of the benefits by showing improvements in heart blood flow.
The researchers utilized a technique known as quantitative perfusion magnetic resonance imaging (MRI) to measure blood flow through the smallest vessels in the heart muscle. This advanced imaging allowed them to observe the direct effects of weight loss surgery on heart function.
Before undergoing surgery, the patients had a median body mass index (BMI) of 44 kg/m², which is classified as severe obesity.
Compared to age- and sex-matched volunteers with an average BMI of 25 kg/m², the patients exhibited thicker heart walls, a sign that their hearts were working harder to pump blood, and reduced blood flow through their heart muscle.
Six months after surgery, the patients experienced significant weight loss, averaging 29 kilograms. Notably, 13 out of 17 patients who had type 2 diabetes before surgery were in remission by the follow-up.
The repeated heart scans showed an increase in blood flow through the heart muscle, indicating improved cardiovascular health.
Additionally, patients showed decreased levels of triglycerides (a type of fat in the blood) and increased levels of HDL (“good”) cholesterol. There was also a reduction in liver fat and lower blood pressure compared to their pre-surgery levels.
Dr. George Joy, another researcher involved in the study, highlighted that these findings offer valuable insights into how weight loss associated with bariatric surgery could lead to better health outcomes for people living with obesity.
He emphasized that similar heart benefits have been observed in trials involving weight loss medications, suggesting that more research is needed to explore whether these mechanisms are consistent across different weight loss strategies.
Dr. Sonya Babu-Narayan, Associate Medical Director at the British Heart Foundation and a consultant cardiologist, stressed the importance of recognizing the link between obesity and heart disease risk.
While not everyone may require surgery or medication to lose weight, it’s crucial that weight-loss treatments and support are accessible to those in need. She also pointed out the broader societal challenge of ensuring that healthy choices are the easiest, most affordable, and most accessible options for everyone.
Dr. Babu-Narayan advocated for measures such as restrictions on junk food advertising to help support people in maintaining a healthy weight.
This study underscores the potential of weight loss surgery not only to aid in significant weight reduction but also to improve cardiovascular health and reduce the risk of heart failure in individuals struggling with obesity.
As the medical community continues to explore various approaches to weight management, the findings offer hope for better health outcomes and a potential pathway to reversing some of the damage caused by obesity.
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The research findings can be found in JACC: Cardiovascular Imaging.
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