Article

AIMS: To investigate the effect of weight loss induced by bariatric surgery and
intensive lifestyle intervention on levels of circulating high-sensitivity
cardiac troponin I. METHODS : We measured high-sensitivity cardiac
troponin I concentrations pre- and 12 months post-intervention in 136 subjects
with morbid obesity participating in a controlled clinical trial comparing the
effect of intensive lifestyle intervention vs. Roux-en-Y gastric bypass. At
baseline median (interquartile range) high-sensitivity cardiac troponin I levels
were 2.40 (1.28-3.95) ng/L in the bariatric surgery group and 2.35 (1.38-4.40)
ng/L in the intensive lifestyle intervention group (p = 0.736). The
high-sensitivity cardiac troponin I concentration in a normal-weight control
group was 0.90 (0.60-2.13) ng/L. During 12 months of follow-up, high-sensitivity
cardiac troponin I decreased significantly more in the bariatric surgery group
than in the intensive lifestyle intervention group (0.80 (0-1.80) vs. 0.15 (-0.50
to 1.00) ng/L; p = 0.002). In a multivariate logistic regression model, surgery
emerged as a predictor of reduction in high-sensitivity cardiac troponin I levels
(odds ratio 2.32; 95% confidence intervals 1.03-5.22; p = 0.041) independent of
age, gender and other possible confounding baseline variables. In subsequent
multivariate analyses, reductions in body weight and triglycerides emerged as
possible mediators of reduction in circulating levels of high-sensitivity cardiac
troponin I. CONCLUSION: In patients with morbid obesity, bariatric surgery was
associated with a significantly greater reduction in high-sensitivity cardiac
troponin I, an index of subclinical myocardial injury, than intensive lifestyle
intervention. The reduction appeared to be mediated by reductions in body weight
and serum triglycerides.
This suggests that weight loss following bariatric
surgery may reduce cardiometabolic stress and subsequent risk of heart failure.
CI - (c) The European Society of Cardiology 2015.

Langue : ANGLAIS