MedicalResearch.com Interview with:
Yuichi Shimada, MD, MPH
Cardiology Division, Massachusetts General Hospital
A Teaching Affiliate for Harvard Medical School
Boston, MA 02115
Medical Research: What is the background for this study?
Dr. Shimada: Heart failure (HF) is an important public health issue. The United States also has experienced an obesity epidemic. Studies have shown an association between obesity and heart failure-related morbidity. However, little is known about whether substantial weight loss, enabled by bariatric surgery, results in a decreased rate of HF-related adverse events. In this context, we investigated whether bariatric surgery is associated with significantly reduced rates of ED visits and hospitalizations for heart failure exacerbation among obese patients with heart failure.
Medical Research: What are the main findings?
Dr. Shimada: Among 524 patients with heart failure who underwent bariatric surgery, 16.2% had an ED visit or hospitalization for heart failure exacerbation before surgery. We observed a non-significant but a slight decline in the exacerbation rate (12.0%, p = 0.052) within 12 months after surgery. Then, the rate of heart failure exacerbation went down dramatically, to about half, in the subsequent 13 to 24 months after surgery (9.9%; adjusted odds ratio: 0.57; p = 0.003).
Medical Research: What should clinicians and patients take away from your report?
Dr. Shimada: The rate of ED visits or hospitalizations for heart failure exacerbation was reduced by about 40% after bariatric surgery. For patients with HF and morbid obesity, clinicians should discuss the option of bariatric surgery as a method to achieve substantial and sustained weight reduction, as it may prevent future ED visits and hospitalizations for heart failure exacerbation.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Shimada: Further research is needed to understand the mechanism by which bariatric surgery is associated with reduced risk of heart failure exacerbations.
Medical Research: Is there anything else you would like to add?
Response: Because a large proportion of obese patients with heart failure would not undergo bariatric surgery for various reasons, including initial high cost and risk of peri-surgical complications, we would also like to stress the importance of developing effective non-surgical interventions that achieve a substantial and sustained weight reduction.
Yuichi Shimada (2016). ED Visits and Hospitalizations for Heart Failure After Bariatric Surgery Drop