Impact of obesity and bariatric surgery on metabolism and coronary circulatory function.

Ines Valenta, Vasken Dilsizian, Alessandra Quercioli, Freimut D. Jüngling, Giuseppe Ambrosio, Richard Wahl, Thomas H. Schindler

Research output: Contribution to journalArticle

Abstract

Increases in intra-abdominal visceral adipose tissue have been widely appreciated as a risk factor for metabolic disorders such as dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, whereas this is not the case for peripheral or subcutaneous obesity. While the underlying mechanisms that contribute to these differences in adipose tissue activity remain uncertain, increases in visceral fat commonly induce metabolic dysregulation, in part because of increased venous effluent of fatty acids and/or adipokines/cytokines to the liver. Increased body weight, paralleled by an increase in plasma markers of the insulin-resistance syndrome and chronic inflammation, is independently associated with coronary circulatory dysfunction. Recent data suggest that plasma proteins originating from the adipose tissue, such as endocannabinoids (EC), leptin, and adiponectin (termed adipocytes) play a central role in the regulation and control of coronary circulatory function in obesity. Positron emission tomography (PET) in concert with tracer kinetic modeling is a well established technique for quantifying regional myocardial blood flow at rest and in response to various forms of vasomotor stress. Myocardial flow reserve assessed by PET provides a noninvasive surrogate of coronary circulatory function. PET also enables the monitoring and characterization of coronary circulatory function in response to gastric bypass-induced weight loss in initially morbidly obese individuals, to medication and/or behavioral interventions related to weight, diet, and physical activity. Whether the observed improvement in coronary circulatory dysfunction via weight loss may translate to diminution in cardiovascular events awaits clinical confirmation.

Original languageEnglish (US)
Pages (from-to)433
Number of pages1
JournalCurrent Cardiology Reports
Volume16
Issue number1
StatePublished - Jan 2014
Externally publishedYes

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Bariatric Surgery
Intra-Abdominal Fat
Positron-Emission Tomography
Obesity
Insulin Resistance
Adipose Tissue
Weight Loss
Endocannabinoids
Adipokines
Gastric Bypass
Adiponectin
Regional Blood Flow
Dyslipidemias
Leptin
Adipocytes
Type 2 Diabetes Mellitus
Blood Proteins
Fatty Acids
Body Weight
Cytokines

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Valenta, I., Dilsizian, V., Quercioli, A., Jüngling, F. D., Ambrosio, G., Wahl, R., & Schindler, T. H. (2014). Impact of obesity and bariatric surgery on metabolism and coronary circulatory function. Current Cardiology Reports, 16(1), 433.

Impact of obesity and bariatric surgery on metabolism and coronary circulatory function. / Valenta, Ines; Dilsizian, Vasken; Quercioli, Alessandra; Jüngling, Freimut D.; Ambrosio, Giuseppe; Wahl, Richard; Schindler, Thomas H.

In: Current Cardiology Reports, Vol. 16, No. 1, 01.2014, p. 433.

Research output: Contribution to journalArticle

Valenta, I, Dilsizian, V, Quercioli, A, Jüngling, FD, Ambrosio, G, Wahl, R & Schindler, TH 2014, 'Impact of obesity and bariatric surgery on metabolism and coronary circulatory function.', Current Cardiology Reports, vol. 16, no. 1, pp. 433.
Valenta I, Dilsizian V, Quercioli A, Jüngling FD, Ambrosio G, Wahl R et al. Impact of obesity and bariatric surgery on metabolism and coronary circulatory function. Current Cardiology Reports. 2014 Jan;16(1):433.
Valenta, Ines ; Dilsizian, Vasken ; Quercioli, Alessandra ; Jüngling, Freimut D. ; Ambrosio, Giuseppe ; Wahl, Richard ; Schindler, Thomas H. / Impact of obesity and bariatric surgery on metabolism and coronary circulatory function. In: Current Cardiology Reports. 2014 ; Vol. 16, No. 1. pp. 433.
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