Object: Cardiovascular autonomic neuropathy (CAN) is one of chronic vascular complications of diabetes, and obesity is a major risk factor for CAN. Metabolic bariatric surgery (MBS) dramatically improved both diabetes and obesity. In this study we investigated the influence of MBS on CAN in Korean subjects with obesity.

Method: We recruited patients who underwent bariatric surgery from October 20to February 2021 prospectively. CAN was evaluated before and 6 months after surgery by Ewing method including change in heart rate (HR) and blood pressure (BP) according to deep breathing, Valsalva maneuver, and postural change by AFT-800 (MEDICORE, Gyeonggi-do, Republic of Korea) . Standard deviation of NN interval (SDNN) , root mean square of successive RR interval difference (RMSSD) , total power, and very low, low, and high frequency were compared before and after surgery.

Result: A total of 22 patients were evaluated. Patients' mean age was 42.1 ± 9.1 years, and 8 patients (36.4%) were male, and the mean follow-up duration was 189.0 days. Among them, 15 (68.2%) subjects had diabetes, and none had cardiovascular disease. The resting HR before surgery was 79.2 ± 13.7 bpm, and it decreased significantly to 67.4 ± 8.2 bpm after surgery (P<0.001) . Changes in HR and BP according to Valsalva maneuver, posture change, and handgrip were not significantly different before and after surgery. However, SDNN significantly increased from 25.3 [13.7-41.8] ms to 35.2 [22.6-40.4] ms (P=0.046) , and RMSSD also tended to increase. In addition, the high frequency significantly increased from 36.1 [16.8-180.3] ms2 to 117.8 [34.6-357.7] ms2 (P=0.042) after surgery.

Conclusion: MBS significantly improved indicators of parasympathetic denervation, an early manifestation of CAN.


H.Jang: None. S.Moon: None. J.Moon: None. Y.Park: None. S.Choi: None. H.Jang: None. T.Oh: None.

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