Severely obese adolescents who undergo bariatric surgery experience
substantial improvements in cardiac geometry, left ventricular mass,
and diastolic function after weight loss, new study findings
indicate.

In fact, reversal of cardiac abnormalities appears to be more likely
in teenagers than in similar adults, Dr. Holly M. Ippisch and
associates report in the April 8 issue of the Journal of the
American College of Cardiology.

"This might be an argument for earlier intervention at younger ages
in severely obese young people," the investigators suggest.

Dr. Ippisch and her colleagues evaluated outcomes for 38 patients
ages 13 to 19 years who underwent laparoscopic Roux-en-Y gastric
bypass surgery at Cincinnati Children's Hospital Medical Center in
Ohio. Weight prior to surgery averaged 175 kg, and mean body mass
index (BMI) was 60 kg/m.

Within the following year, mean weight and BMI fell to 116 kg and 40
kg/m, respectively.

Although most patients were still over their ideal body weight,
heart rate was reduced by 18 beats/min and systolic blood pressure
by 12 mm Hg, changes that "possibly reflect a decreased cardiac work
load," the authors report.

The proportion of patients with normal left ventricular geometry
rose from 36% at baseline to 79%, and left ventricular mass fell
significantly. Doppler imaging also indicated sizable reductions in
posterior wall and septal thicknesses, evidence of myocardial
remodeling that the investigators say has not been observed in
adults.

Despite these promising results in adolescents, the team concludes
that long-term follow-up is required to see if the improvements
persist, and "whether these findings translate into long-term
reduction in their future cardiovascular morbidity during adulthood."

J Am Coll Cardiol 2008;51:1342-1348.