Bariatric chamber
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Impact of Bariatric Surgery on Cardiac Geometry, β Cell Function, and Brain Activity
Bariatric Surgery and Cardiac Geometry
Epicardial Adipose Tissue and Cardiac Remodeling
Bariatric surgery significantly impacts cardiac geometry by reducing epicardial adipose tissue (EAT) and visceral adipose tissue (VAT). This reduction in adipose tissue leads to changes in cardiac geometry, including decreases in left atrial volume (LAV) and left ventricular end-diastolic volume (LVEDV) shortly after surgery. The initial weight loss results in a reduction of both eccentric and concentric cardiac remodeling, with a notable decrease in left ventricular mass (LVM) and improvements in markers of pericardial restraint. However, over the long term, while LVM continues to decrease, LAV and LVEDV tend to return to baseline levels, indicating a biphasic response in cardiac volumes.
Enhanced β Cell Function Post-Bariatric Surgery
Improved Insulin Secretion and Glucose Tolerance
Bariatric surgery, particularly Vertical Sleeve Gastrectomy (VSG), has been shown to enhance β cell function and connectivity within the islets, leading to improved insulin secretion and glucose tolerance. This improvement is partly due to increased circulating levels of GLP-1, which directly and indirectly affect β cell function through weight loss and other metabolic changes. The enhanced β cell connectivity and function contribute significantly to the remission of diabetes observed in many patients post-surgery.
Alterations in Brain Activity Following Bariatric Surgery
Changes in Reward and Taste Perception
Roux-en-Y Gastric Bypass (RYGB) surgery not only facilitates weight loss but also alters brain activity in regions associated with reward and taste perception. Studies in high-fat diet-induced obese rats have shown that RYGB surgery leads to selective activation of brain regions involved in reward anticipation and gustatory processing, such as the cerebellum, medial parabrachial nuclei, and dorsomedial tegmental area. These changes suggest that RYGB modifies the brain's response to highly palatable foods, potentially reducing the reward and motivation associated with food intake, which may contribute to sustained weight loss and altered eating behaviors.
Conclusion
Bariatric surgery induces significant changes in cardiac geometry, β cell function, and brain activity. The reduction in epicardial and visceral adipose tissue post-surgery leads to initial improvements in cardiac remodeling, although some parameters return to baseline over time. Enhanced β cell function and connectivity improve insulin secretion and glucose tolerance, aiding in diabetes remission. Additionally, alterations in brain activity related to reward and taste perception may help sustain weight loss and modify eating behaviors. These multifaceted effects underscore the comprehensive benefits of bariatric surgery beyond mere weight reduction.
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