In what is considered a ground-breaking study, researchers at University College London have claimed that weight loss surgery could majorly lower the risk of heart failure in those who live with obesity by enhancing blood supply to the heart muscle.
It has long been held that obesity is a risk factor for heart failure, in part through actions of decreased blood flow through the small vessels of the heart. However, new research, in which King’s College London collaborated and was funded by the British Heart Foundation, has found these harmful effects could be reversed. The results are published in the Journal of the American College of Cardiology Cardiovascular Imaging.
Researchers used imaging to examine the hearts of 27 patients before, and again six months after, bariatric surgery. The results were promising: Blood flow through small blood vessels in the heart increased, and other risk factors for heart disease showed marked improvement.
“Previous research has demonstrated that weight loss surgery can lower the chance of developing or dying from cardiovascular disease in people living with obesity,” stated study leader Professor Charlotte Manisty of the UCL Institute of Cardiovascular Science. “Our work provides a new additional explanation for the benefits of this intervention.”
The researchers used quantitative perfusion MRI to measure the blood flow through the smallest vessels in heart muscle, before and after the surgery. Before surgery, the patients had a median body mass index of 44 kg/m2 with thicker heart walls and lower blood flow compared with volunteers with an average BMI of 25. Six months after surgery, patients had lost an average of 29 kg, and 13 of the 17 with type 2 diabetes were in remission.
Follow-up imaging revealed increased perfusion of the heart, reduced triglycerides, higher HDL cholesterol, less fatty liver, and lower blood pressure.
“These promising results provide important insights into how weight loss associated with bariatric surgery might improve outcomes for patients living with obesity,” said Dr. George Joy from the UCL Institute of Cardiovascular Science. He added that more studies should be done to determine if these mechanisms function similarly for other means of losing weight, such as weight-loss medications.
Dr. Sonya Babu-Narayan, Associate Medical Director at the British Heart Foundation and consultant cardiologist, commented on the wider implications of the study: “This research yet again underlines the connection between obesity and the risk of developing heart disease.” Not everyone will need surgery or medication to lose weight, but weight loss treatment and support must be accessible to all who need them.
Babu-Narayan also said that there was a need to create an enabling environment for healthy living. “We must press ahead with actions that address our food environment, including implementing restrictions on junk food advertising, so that everyone is supported to maintain a healthy weight,” she said.