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The role of anti-diabetic drugs on the extent of post-bariatric surgery cardiac reverse remodelling
Session:
Sessão de Posters 10 - Cuidados modernos na insuficiência cardíaca: congestão, metabolismo e resultados
Speaker:
Edilson Samuel Paulino Chamba
Congress:
CPC 2026
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.14 Cardiovascular Disease in Special Populations - Other
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Edilson Chamba; Ana Filipa Ferreira; João Sergio Neves; Mariana Pinto; Sara Costa; Fernando Resende; Eduardo Jorge Lima-Da-Costa; Inês Falcão Pires
Abstract
<p style="text-align:start"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:medium"><span style="color:#000000"><strong>Introduction:</strong> <span style="color:black">Obesity induces cardiac remodelling, often asymptomatic, that may precede HF. </span>Bariatric surgery (BS) can lead to weight loss and cardiac reverse remodelling (RR). The impact of anti-diabetic drugs, particularly glucagon-like peptide-1 receptor agonists (GLP1-RA) and sodium-glucose cotransport-2 inhibitors (SGLT2i), on cardiac function and RR remains unclear. </span></span></span></p> <p style="text-align:start"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:medium"><span style="color:#000000"><strong>Aim:</strong> To investigate the effects of BS on cardiac, metabolic, and adipose tissue RR and the influence of pre-surgery GLP1-RA or SGLT2i therapy. </span></span></span></p> <p style="text-align:start"><br /> <span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:medium"><span style="color:#000000"><strong>Methods:</strong> We recruited 19 obese participants (mean age 50 ± 10 years; 9 females, 10 males) with preserved ejection fraction, scheduled for BS at a tertiary center from October 2024 to April 2025. Participants underwent transthoracic echocardiography (TCC), pulse wave velocity analysis, and bioelectrical impedance analysis (BIA), as well as a 6-minute walk test (6MWT) and the Kansas-City Cardiomyopathy Questionnaire (KCCQ), immediately before BS (T0) and three-months post-BS (T1). Visceral adipose tissue (VAT) was collected for histomorphometric analysis. Participants were divided into two groups: those receiving GLP1-RA or SGLT2i therapy (BARD group, n=8) and those not receiving it (CTRL group, n=11). Statistical analyses included t-tests, Mann–Whitney tests, chi-square tests, and mixed-effects models (p<0.05).</span></span></span></p> <p style="text-align:start"><br /> <span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:medium"><span style="color:#000000"><strong>Results:</strong> Significant weight loss was confirmed at follow-up, along with reductions in total fat mass (−29%, p<0.001) and visceral fat area (−28%, p=0.003). Despite no significant changes in walking distance, there was a marked improvement in exercise tolerance as shown by higher end-exercise oxygen saturation (+3%, p=0.030), decreased dyspnoea (-2 points, p=0.001), going accordingly with improvement in physical limitations (+22 points, p=0.001), and quality of life (+29 points, p<0.001) observed. Cardiac and vascular RR patterns were similar between groups post-BS. However, the BARD group had a higher relative wall thickness at baseline (p=0.020). VAT analysis showed increased fibrosis in the BARD group (p=0.042) compared to CTRL, with no significant differences in adipocyte size. No additional differences were observed between groups in the other parameters evaluated.</span></span></span></p> <p style="text-align:start"><br /> <span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:medium"><span style="color:#000000"><strong>Conclusion: </strong>BS led to significant symptomatic and metabolic improvements, as evaluated through KCCQ, 6MWT, and BIA. Pre-surgery anti-diabetic therapy influenced cardiac RR in the BARD group, seen as a greater reduction of RWT. However, no differences were observed in other echocardiographic or vascular variables.</span></span></span></p>
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