Abstract MP86: Hemodynamic and Metabolomic Change From Lifestyle Driven Weight Loss in Obese Adolescents

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Justin P Zachariah ◽  
Jane W Newburger ◽  
Gary F Mitchell
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Heart Rate ◽  
Weight Loss ◽  
Augmentation Index ◽  
Free Play ◽  
Metabolomic Analysis ◽  
Entry And Exit ◽  
Obese Adolescent ◽  
Obese Adolescents

Background: While bariatric surgery is known to induce hemodynamic and metabolic pathway alterations, lifestyle-driven weight loss in obese adolescents are not well characterized with respect to hemodynamic and metabolomic effects. We studied aortic function and urine metabolomics changes in obese adolescent volunteers attending weight loss summer camps. Methods: Adolescents (n=45, 71% girls, mean age 15±1 year) attending long-standing weight loss camps over 3 summers volunteered to have weight, long term diet and activity history, and vascular tonometry after overnight fast at camp entry and exit. A subset (n=32) also gave urine entry and exit urine samples for metabolomic analysis (Metabolon, Durham NC). Camp administrators followed pre-existing protocols encouraging campers toward 5 hours or more of structured activity and free play as well as nutritionist-designed meal plan restricted to age-sex specific calorie goals. Paired students T-tests were used to assess changes in anthropometrics and hemodynamics. Osmolality-adjusted metabolomic changes were analyzed using principal components analysis; paired T-test with multiple comparison adjustment by Storey-Tibshirani false discovery rate thresholding; and Random Forest decision tree ensembles with selection of the top 30 biochemicals in variable importance gleaned from the Mean Decrease Accuracy metric, which randomly permutes a given chemical and reassesses predictive accuracy throughout the tree ensembles, and then grouped into pathway categories. Results: Median camp length was 6 weeks (25%,75% IQR 5,7). Campers on average lost body 11±4% of body weight (99±20 to 88±17 kilograms, p<0.0001). Supine systolic blood pressure declined from 115±11 to 111±12 mmHg (p<0.01), diastolic blood pressure from 57±8 to 52±7 mmHg (p<0.0001), and heart rate from 73±10 to 62±11 beats per minute (p<0.0001). Carotid femoral pulse wave velocity decreased from 5.4±0.7 to 5.1±0.6 meters per second (p<0.0001). This change in arterial stiffness was not dependent on changes in heart rate nor distending pressure. Augmentation index did not significantly change from 17±11% to 16±9% (p=0.5). On urine metabolomic analysis, altered biochemical pathways included lipid metabolism, bile acids, and carbohydrate excretion. Conclusions: Diet and activity driven weight loss in excess weight adolescents is associated with salutary hemodynamic improvement and specific metabolic alterations, paralleling findings after bariatric surgery. More investigation into the mechanisms of lifestyle driven weight loss is warranted.

Abstract 15291: ‘Heart Rate Deficit’ From Dysautonomia in a Bariatric Surgery Patient - An Unusual Cause of Recurrent Syncope

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Krishna Akella ◽  
Ghulam Murtaza ◽  
iftekhar Ahmed ◽  
LUIS Couchonnal ◽  
Yoaav Krauthammer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Heart Rate ◽  
Weight Loss ◽  
Pacemaker Implantation ◽  
Permanent Pacemaker ◽  
Exercise Intolerance ◽  
Significant Weight Loss ◽  
Permanent Pacemaker Implantation ◽  
Post Surgery

Background: Patients undergoing bariatric surgery are prone to develop symptomatic dysautonomia but the mechanisms remain unclear. Methods: N/A Results: A 61-year-old female with hyperlipidemia, fibromyalgia, morbid obesity status post gastric sleeve 2 years prior, was transferred to our institution after an unremarkable initial cardiac workup for recurrent syncope and bradycardia. Patient had significant weight loss (180 lbs) post-surgery over this 2-year period but began noticing increasing fatigue, and exercise intolerance in the last four months preceding recent syncopal episodes. Syncopal spells happened while trying to lift her head >60 degrees/sit up from a recumbent position. Baseline heart rate (HR) was 36-42 bpm (Figure lower Panel) while it was 75-90 bpm immediately following bariatric surgery (Figure upper panel). Blood pressure was normal. During witnessed syncopal episodes, HR remained in the 35-40 bpm range with no asystolic pauses and normal blood pressure. Video EEG showed loss of brain electrical activity during syncope; no seizure activity was noted. Progressive decline in HR and baseline bradycardia was suspected as the cause and she underwent permanent pacemaker implantation, which resulted in complete resolution of symptoms and no recurrence of syncope at 6-mo follow-up. Conclusion: We describe a unique case where marked decline in resting HR occurred in association with significant weight loss following bariatric surgery. This ‘HR deficit’ and resting bradycardia, likely due to dysautonomia, resulted in recurrent syncope without asystole or vasodepression, and completely resolved with permanent pacemaker implantation.

scholarly journals Improved blood pressure, nitric oxide and asymmetric dimethylarginine are independent after bariatric surgery

2012 ◽  
Vol 49 (6) ◽  
pp. 589-594 ◽  
Author(s):  
R Patle ◽  
S Dubb ◽  
J Alaghband-Zadeh ◽  
R A Sherwood ◽  
F Tam ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Asymmetric Dimethylarginine ◽  
Obese Patients ◽  
Endogenous Inhibitor ◽  
Nitrite Concentration ◽  
Plasma Adma ◽  
Adma Concentration

Background Obesity is associated with hypertension, but the exact mechanism is not fully understood. Bariatric surgery significantly decreases weight and blood pressure (BP). Low plasma nitric oxide (NO) and raised asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO, concentrations are associated with both obesity and hypertension. Correlations between the changes in these parameters were studied after bariatric surgery. Methods Weight, BP, plasma ADMA and NO were measured in 29 obese patients (24 female, 5 male) before and six weeks after bariatric surgery. Results Patients were 39.2 ± 1.2 (mean ± SEM) years old and weighed 126 ± 3 kg. Six weeks after the surgery, patients had lost 10 ± 0.7 kg ( P < 0.0001) and mean arterial pressure (MAP) decreased by 11 ± 1.0 mmHg ( P < 0.0001). The plasma ADMA concentration decreased by 24 ± 2% from 5 ± 0.4 to 4.0 ± 0.3 μmol/L ( P < 0.0001). The plasma total nitrite concentration increased by 15 ± 1% from 51.4 ± 2.6 to 60 ± 3 μmol/L ( P < 0.0001). The correlation between the decrease of ADMA and increase of NO subsequent to weight loss was significant ( P < 0.0001). However, MAP was not correlated to the changes in ADMA or NO. Conclusions After bariatric surgery, beneficial changes in BP, NO and ADMA occur, but our findings suggest that these BP changes are independent of changes in the NO–ADMA axis. Other causes for the changes in BP should therefore be considered.

Cardiovascular Effects of Aerobic Exercise With Self-Selected or Predetermined Intensity in Adolescents With Obesity

2021 ◽  
pp. 1-7
Author(s):  
Tércio A.R. Barros ◽  
Wagner L. do Prado ◽  
Thiago R.S. Tenório ◽  
Raphael M. Ritti-Dias ◽  
Antônio H. Germano-Soares ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Heart Rate ◽  
Pulse Pressure ◽  
Exercise Intensity ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Cardiovascular Effects ◽  
Heart Rate Reserve ◽  
Central Pulse Pressure

This study compared the effects of self-selected exercise intensity (SEI) versus predetermined exercise intensity (PEI) on blood pressure (BP) and arterial stiffness in adolescents with obesity. A total of 37 adolescents, 14.7 (1.6) years old, body mass index ≥95th percentile were randomly allocated into SEI (n = 18; 12 boys) or PEI (n = 19; 13 boys). Both groups exercised for 35 minutes on a treadmill, 3 times per week, for 12 weeks. The SEI could set the speed at the beginning of the sessions and make changes every 5 minutes. The PEI adolescents were trained at an intensity set at 60% to 70% of heart rate reserve. Brachial and central BP, pulse pressure, augmentation index, and carotid–femoral pulse wave were determined at baseline and after 12 weeks. Both groups reduced brachial systolic BP (SEI, Δ = −9 mm Hg; PEI, Δ = −4 mm Hg; P < .01), central systolic BP (SEI, Δ = −4 mm Hg; PEI, Δ = −4 mm Hg; P = .01), and central pulse pressure (SEI, Δ = −4 mm Hg; PEI, Δ = −3 mm Hg; P = .02) without differences between groups. No changes in the augmentation index and carotid–femoral pulse wave were observed in either group. The SEI induced similar changes in various cardiovascular outcomes compared with PEI in adolescents with obesity.

Omentin-1 Changes following Biliopancreatic Diversion and Relationship with Cardiovascular Risk Factors

2018 ◽  
Vol 73 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Daniel Antonio de Luis ◽  
Susana García Calvo ◽  
Juan Jose Lopez Gomez ◽  
Olatz Izaola ◽  
David Primo ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Biliopancreatic Diversion ◽  
Fat Mass ◽  
Fasting Blood Glucose ◽  
Fasting Insulin ◽  
Post Surgery ◽  
Biliopancreatic Diversion Surgery

Introduction: Omentin-1 might play a role in the pathogenesis of insulin resistance and obesity. The aim of the present study was to evaluate the influence of weight loss after biliopancreatic diversion on serum omentin-1 concentrations. Material and Methods A Caucasian population of 24 morbid obese patients was analyzed before and after 12 months of a biliopancreatic diversion surgery. Biochemical and anthropometric evaluation were realized at basal visit and at 12 months. Body weight, fat mass, waist circumferences, blood pressure, fasting blood glucose, fasting insulin, insulin resistance (HOMA-IR), lipid concentrations and omentin-1 were measured. Results: After bariatric surgery and in both gender groups (males vs. females); BMI, weight, fat mass, waist circumference, blood pressure, glucose , total cholesterol, LDL cholesterol, triglycerides, HOMA-IR and fasting insulin decreased in a statistical manner from basal values. Omentin-1 levels increased after bariatric surgery and in both gender the improvement was similar (males vs. females); (delta: –87.1 ± 19.0 ng/dL; p = 0.02 vs. –93.8 ± 28.1 ng/dL; p = 0.03). In the multiple regression analysis adjusted by age and sex; BMI kg/m2 (Beta –0.32: 95% CI –3.98 to –0.12) and insulin UI/L (Beta –0.41: 95% CI –8.38 to –0.16) remained in the model with basal omentin-1 levels as dependent variable. The regression model with post-surgery omentin-1 levels as dependent variable showed as independent variables BMI kg/m2 (Beta –0.13: 95% CI –7.69 to –0.09) and insulin UI/L (Beta –0.24: 95% CI –5.69 to –0.08), too. Conclusion: This study showed a significant increase in omentin-1 levels after weight loss secondary biliopancreatic diversion surgery. A weak negative correlation with BMI and basal insulin levels was detected.

Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease

2021 ◽  
Author(s):  
Hélcio Kanegusuku ◽  
Gabriel Grizzo Cucato ◽  
Paulo Longano ◽  
Erika Okamoto ◽  
Maria Elisa Pimentel Piemonte ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Cardiovascular Responses ◽  
Cycle Ergometer ◽  
Control Session ◽  
Wave Analysis

AbstractParkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.

Weight loss after bariatric surgery in obese adolescents: a systematic review and meta-analysis

2018 ◽  
Vol 14 (3) ◽  
pp. 413-422 ◽  
Author(s):  
Felipe E. Pedroso ◽  
Federico Angriman ◽  
Atsushi Endo ◽  
Hormuzdiyar Dasenbrock ◽  
Alessandra Storino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Meta Analysis ◽  
Obese Adolescents

24-h Systolic blood pressure and heart rate recordings in lean and obese adolescents

2006 ◽  
Vol 26 (4) ◽  
pp. 235-239 ◽  
Author(s):  
Jenny Framme ◽  
Frida Dangardt ◽  
Staffan Marild ◽  
Walter Osika ◽  
Peter Wahrborg ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Obese Adolescents

scholarly journals Including Mixed Tree Nut Snacks in a Weight Loss and Weight Maintenance Intervention Resulted in Weight Loss and Increased Satiety

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 320-320
Author(s):  
Susanne Henning ◽  
Jing Wang ◽  
Sijia Wang ◽  
Tianyu Qin ◽  
Yajing Pan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Weight Loss ◽  
Oleic Acid ◽  
Diastolic Blood Pressure ◽  
Weight Maintenance ◽  
Tree Nuts ◽  
Weight Loss Diet ◽  
Tree Nut ◽  
Maintenance Program

Abstract Objectives Tree nuts are an excellent dietary source of protein and healthy fat leading to increased satiety. Tree nuts also provide polyphenols, vitamins and minerals supporting the immune response. However, there is a concern that tree nuts are not suitable to be included in a weight loss diet due to their fat content. Therefore, it was the objective of the study to test whether including mixed tree nuts in a weight loss and maintenance program will lead to weight loss by increasing satiety and decreasing inflammation. Methods We performed a randomized, controlled, two-arm study in 95 overweight individuals consuming 1.5 oz of mixed tree nuts daily (n = 56) or equal amount of calories in the form of a pretzel snack (n = 39) as part of a hypocaloric weight loss diet (−500 calories of resting metabolic rate) for 12 wks followed by an isocaloric weight maintenance program for an additional 12 wks. Results The dropout rate was significantly lower in the tree nut (16.4%) compared to the pretzel (35.9%) group. Participants experienced significant weight loss (12 wks: −1.6 and −1.9 and 24 wks: −1.5 kg and −1.4 kg) in the tree nut and pretzel group, respectively, without difference between groups at any time point. In addition, both groups showed a significant decrease in diastolic blood pressure at 12 wks and a significant increase in satiety at 24 wks, but only participants in the mixed tree nut group showed significant decrease in heart rate at 4, 12 and 24 wks. Plasma oleic acid concentration was significantly increased at 12 and 24 wks in the tree nut group, while in the pretzel group plasma oleic acid was significantly increased and stearic acid decreased at 12 wks and linolenic acid was increased at 24 wks. No change in fasting plasma triglyceride, total cholesterol and HDL-cholesterol was observed in both groups. No change in inflammatory markers except plasma MCP-1 was decreased significantly in the tree nut group at 4 wks. Conclusions In summary, including mixed tree nuts in a weight loss and maintenance diet can maintain compliance and promote weight loss similar to standard weight loss and maintenance diets. Although both, the mixed tree nut diet and pretzel diet resulted in decreased diastolic blood pressure, only consumption of the mixed tree nut diet led to significantly decreased heart rate and increased study retention. Funding Sources International Tree Nut Council.

scholarly journals Relationship between fat distribution ratio and blood pressure in obese adolescents

2016 ◽  
Vol 48 (5) ◽  
pp. 274
Author(s):  
Henny Marina ◽  
Dany Hilmanto ◽  
Julistio Tb Djais
Keyword(s):  
Blood Pressure ◽  
Body Fat ◽  
Pearson Correlation ◽  
Fat Distribution ◽  
Body Fat Distribution ◽  
Cross Sectional ◽  
Obese Adolescent ◽  
Waist To Hip Ratio ◽  
Obese Adolescents ◽  
Central Fat

Background The incidence of obesity in big cities increasessignificantly. The association between obesity and increased riskof cardiovascular disease and hypertension in adults has beenknown but less information is available in adolescents. Similarly,the relationship between body-fat distribution and cardiovasculardiseases in adolescents is less clear tha that in adults.Objective This study aimed to determine the association betweenbody fat distribution and increased blood pressure in obeseadolescents in Bandung.Methods This cross-sectional study was conducted from June toAugust 2006. Subjects were students aged 15-18 years at highschools in Bandung with body mass index (BMI) measured usingCDC chart 2000 (> P95) and increased blood pressure (> P90)depended on age and gender according to National High BloodPressure Education Program Working Group on High BloodPressure in Children and Adolescents 2004. Waist-to-hip ratio(central fat), and subscapula skinfold-to-triceps skinfold ratio(peripheral fat) were used to measure fat distribution. Correlationbetween body fat distribution and blood pressure was analyzedusing Pearson correlation statistical test.Results Out of 3170 adolescents examined, 34 obese adolescentgirls and 43 obese adolescent boys had increased blood pressure.Correlation between waist-to-hip ratio and systole blood pressurein boys showed by r=0.495; P=0.003 and girls showed r=0.494;P=O.OOl. Correlation between subscapula skinfold-to-tricepsskinfold ratio in boys showed r=0.289; P=0.097 and girls showedby r=0.248; P=0.109.Conclusion Central fat is moderately correlated with increasedblood pressure in obese adolescents.

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