Diastolic Dysfunction, Heart Failure With Preserved Ejection Fraction (HFPEF), Obesity
Conditions
Brief summary
The goal of this observational study is to learn if weight loss surgery can lower fat inside the heart muscle and improve how the heart relaxes in adults with obesity. The main questions it aims to answer are: Does fat inside the heart muscle decrease after weight loss surgery? Does heart relaxation (diastolic function) improve after surgery? Are changes in heart fat linked to changes in weight, body fat, and blood markers? Participants who are already planning to have weight loss surgery will take part in this study. Participants will: Have a heart CT scan to measure fat in the heart muscle before surgery and about 6 months after surgery Have an ultrasound of the heart (echocardiogram) to check how the heart fills and relaxes Have body composition testing to measure fat and muscle Have blood tests, including routine tests and additional markers related to heart function and metabolism Researchers will compare each participant's results before and after surgery to see if heart fat decreases and if heart function and blood markers improve.
Interventions
None listed
Sponsors
Itshak Amsalem
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Adults aged 18 years or older * Scheduled to undergo bariatric surgery for standard clinical indications * Left ventricular ejection fraction (LVEF) ≥50% * Able to undergo cardiac computed tomography (CT)
Exclusion criteria
* Left ventricular ejection fraction (LVEF) \<50% * Known cardiomyopathies, including sarcoidosis, amyloidosis, or myocarditis * Significant valvular heart disease * Contraindication to cardiac CT (e.g., severe renal dysfunction, contrast allergy) * Presence of intracardiac or cardiac-related foreign material that may interfere with imaging (e.g., prosthetic valves, pacemakers, prior transcatheter devices)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in intramyocardial fat content assessed by cardiac CT | Baseline to 6 months | Change in intramyocardial fat quantified from cardiac computed tomography (CT) between baseline (pre-surgery) and 6 months after bariatric surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation coefficient between change in intramyocardial fat and change in diastolic function grade | Baseline to 6 months | Correlation coefficient (unitless) between change in intramyocardial fat, quantified by cardiac computed tomography (CT) as a percentage of myocardial volume, and change in diastolic function grade assessed by transthoracic echocardiography according to guideline-based criteria |
| Change in diastolic function grade | Baseline to 6 months | Change in diastolic function grade assessed by transthoracic echocardiography according to standard guideline-based criteria (including parameters such as E/e', left atrial volume index, and other measures of left ventricular filling pressures) between baseline and 6 months |
| Change in body composition | Baseline to 6 months | Change in total fat mass and lean body mass assessed by body composition analysis between baseline and 6 months |
| Change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) | Baseline to 6 months | Change in N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration, measured in pg/mL using standard laboratory assays, between baseline and 6 months |
| Change in pericardial fat volume | Baseline to 6 months | Change in pericardial fat volume quantified from cardiac computed tomography (CT) between baseline (pre-surgery) and 6 months after bariatric surgery |
| Correlation coefficient between change in intramyocardial fat and change in body weight | Baseline to 6 months | Correlation coefficient (unitless) between change in intramyocardial fat, quantified by cardiac CT as a percentage of myocardial volume, and change in body weight measured in kilograms |
Contacts
CONTACTItshak Amsalem, MD
Outcome results
None listed