BS O07 Short-Term and Long-Term Changes in Natriuretic Peptide Levels After Bariatric Surgery: A Meta-Analysis

Abstract

Abstract Background Bariatric surgery (BS) has demonstrated cardiovascular benefits in patients and was previously proven to be associated with an increased natriuretic peptide level without cardiac dysfunction. However, new studies have emerged, which require us to re-examine the relationship and extent of the correlation between BS, weight loss, and cardiac natriuretic peptide levels. Methods A PRISMA-compliant systematic search was conducted across Medline, Cochrane, and Embase, until 15th February 2023. Primary outcomes include short- and long-term changes in B-type natriuretic peptide (BNP) and N-terminal pro BNP (NT-proBNP) post-BS. Secondary outcomes included changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), atrial natriuretic peptide (ANP), N-Terminal atrial natriuretic peptide (NT-ANP), ejection fraction (EF) and left ventricular mass (LVM). Outcomes were pooled using the DerSimonian and Laird random effects model. Results Twenty-two studies with 1219 patients (33.2% Male, 45.5% gastric bypass surgery). Mean difference of short- and long-term NT-proBNP levels after BS were 52.88 pg/mL (95% CI, 21.30-84.46) and 50.42 pg/mL (95% CI, 28.18-72.67) respectively with a similar rise observed in BNP levels. Short-term NT-ANP levels significantly increased, but not in long-term ANP and short-term NT-ANP levels. There were no significant post-BS changes in EF but SBP, DBP and LVM significantly reduced. Subgroup analysis in NT-proBNP levels demonstrated a significant rise among patients with >30% BMI loss and a significant reduction in patients with <30% BMI loss. Conclusions BS is associated with increased natriuretic peptide levels in the absence of deteriorating cardiac function. Further studies should investigate its correlation with clinical symptoms, cardiac structural changes and the longitudinal risk of heart failure, enabling informed decision-making and tailored management strategies to optimize patient care and improve postoperative cardiac outcomes in the context of BS.