Abstract 18255: Gastric Mucosal Devitalization Reduces Blood Pressure, Cardiac Lipotoxicity and Endothelial Function in Diet Induced Obese Rats

Abstract

Background: Metabolic surgery induces a substantial reduction in cardiovascular mortality and comorbidities such as blood pressure (BP), cardiac lipotoxicity and endothelial function. Metabolic surgery, such as vertical sleeve gastrectomy (VSG), reduces gastric volume and excludes the gastric mucosa. The gastric mucosa is recognized as an endocrine organ and is involved in the regulation of neurohormonal pathways effecting cardiovascular status. Our study aims to investigate the independent effects of altering gastric mucosa on blood pressure, cardiac lipotoxicity and vascular function in a diet induced obese rat model. Methods: Four-week old male Sprague-Dawley rats were fed a high fat diet for 11 weeks. At week 15, HFD rats (n=64) were randomized to undergo either gastric mucosal devitalization GMD, VSG or Sham (SH) surgery with HFD being continued in all cohorts. GMD of 80% of the stomach was achieved by argon plasma coagulation and compared to VSG and SH. At 8 weeks follow-up (week 23), we quantified blood pressure, cardiac lipid content (ELISA) and related metabolic active proteins adipophilin and periphilin (western blott analysis). Additionally we measured acetylcholine-induced relaxation response of aortic rings. Results: GMD and VSG resulted in a significant reduction of arterial blood pressure (MABP) compared to sham. Cardiac lipid content was significantly reduced in GMD (41%) and VSG (53) compared with SH. Adipophilin was significantly increased in GMD and VSG compared to SH, whereas periphilin was significantly opposite regulated in both intervention groups compared to SH. Area under the curve (AUC) for aortic ring relaxation was statistically relevant lower both in GMD and VSG compared to SH. Conclusions: Devitalization of the gastric mucosa (independent of altering gastric volume) reduces blood pressure, cardiac lipid content and regulate metabolic active proteins involved in cardiac muscle lipid storage as well as vascular function. Therefore, GMD deserves further attention as a promising method to treat obesity related cardiovascular comorbidities.