Improvement in coronary circulatory function in morbidly obese individuals after gastric bypass-induced weight loss: Relation to alterations in endocannabinoids and adipocytokines

Alessandra Quercioli, Fabrizio Montecucco, Zoltan Pataky, Aurelien Thomas, Giuseppe Ambrosio, Christian Staub, Vincenzo Di Marzo, Osman Ratib, Francois Mach, Alain Golay, Thomas H. Schindler

Research output: Contribution to journalArticlepeer-review

Abstract

AimsTo investigate the effect of surgical gastric bypass-induced weight loss and related alterations in endocannabinoids (ECs) and adipocytokine plasma levels on coronary circulatory dysfunction in morbidly obese (MOB) individuals.Methods and resultsMyocardial blood flow (MBF) responses to cold pressor test (CPT) from rest (ΔMBF) and during pharmacologically induced hyperaemia were measured with 13N-ammonia PET/CT in 18 MOB individuals with a body mass index (BMI) > 40 kg/m2 at baseline and after a median follow-up period of 22 months. Gastric bypass intervention decreased BMI from a median of 44.8 (inter-quartile range: 43.3, 48.2) to 30.8 (27.3, 34.7) kg/m2 (P < 0.0001). This decrease in BMI was accompanied by a marked improvement in endothelium-related ΔMBF to CPT and hyperaemic MBFs, respectively [0.34 (0.18, 0.41) from 0.03 (-0.08, 0.15) mL/g/min, P = 0.002; and 2.51 (2.17, 2.64) from 1.53 (1.39, 2.18) mL/g/min, P < 0.001]. There was an inverse correlation between decreases in plasma concentrations of the EC anandamide and improvement in ΔMBF to CPT (r = -0.59, P = 0.009), while increases in adiponectin plasma levels correlated positively with hyperaemic MBFs (r = 0.60, P = 0.050). Conversely, decreases in leptin plasma concentrations were not observed to correlate with the improvement in coronary circulatory function (r = 0.22, P = 0.400, and r = -0.31, P = 0.250).ConclusionsGastric bypass-related reduction of BMI in MOB individuals beneficially affects coronary circulatory dysfunction. The dysbalance between ECs and adipocytokines appears to be an important determinant of coronary circulatory function in obesity.

Original languageEnglish (US)
Pages (from-to)2063-2073
Number of pages11
JournalEuropean heart journal
Volume34
Issue number27
DOIs
StatePublished - Jul 14 2013

Keywords

  • Adipocytokines
  • Coronary circulation
  • Endocannabinoids
  • Endothelium
  • Myocardial blood flow
  • Obesity
  • Positron emission tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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