Abstract
Background
Retinal microvascular diameters and large artery stiffness are valid biomarkers of cardiovascular risk. This study assessed short- and long-term micro- and macrovascular improvements after bariatric surgery (BS).
Methods
Sixteen patients (44 ± 12 years) underwent BS in this observational study. Two weeks before as well as 6 weeks and 4 years after surgery, retinal vessel analysis and assessment of brachial-ankle pulse wave velocity (baPWV), cardio-ankle vascular index (CAVI), and anthropometry were performed. Three patients were lost to follow-up.
Results
Six weeks after BS, retinal arteriolar diameters (CRAE) were wider (180.1 μm vs. 188.1 μm; p = 0.001), and the arteriolar-to-venular diameter ratio (AVR) was higher (0.82 vs. 0.86; p < 0.001) compared to baseline levels. During the 4 years of follow-up, the retinal changes sustained but further improvements did not occur. Both indices of large artery stiffness, baPWV and CAVI, remained unchanged 6 weeks and 4 years after surgery.
Conclusions
Retinal microvascular phenotype improved 6 weeks after BS. The improvements in microvascular health were maintained during 4 years of follow-up but, despite significant further reductions in body mass index, did not improve further long-term. baPWV and CAVI were unaffected after surgery indicating that BS primarily affects microvascular phenotype rather than large artery stiffness. Retinal vessel imaging seems to be a feasible diagnostic tool to monitor microvascular health after BS. Normalization of BMI and blood pressure may be necessary to achieve long-term improvement of large artery phenotype after BS.
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Abbreviations
- AVR:
-
retinal arteriolar-to-venular diameter ratio
- baPWV:
-
brachial-ankle pulse wave velocity (m/s)
- BMI:
-
body mass index (kg/m2)
- BS:
-
bariatric surgery
- CAVI:
-
cardio-ankle vascular index
- CRAE:
-
central retinal arteriolar equivalent (μm)
- CRVE:
-
central retinal venular equivalent (μm)
- MAP:
-
mean arterial pressure (mmHg)
- PWV:
-
pulse wave velocity (m/s)
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We would like to thank all study participants and supporting staff wholeheartedly, which facilitated the study.
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Streese, L., Königstein, K., Goricki, L. et al. Short- and Long-Term Effects of Bariatric Surgery on Vascular Phenotype. OBES SURG 29, 1301–1308 (2019). https://doi.org/10.1007/s11695-018-03679-2
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DOI: https://doi.org/10.1007/s11695-018-03679-2