GASTRIC BYPASS EFFECTS ON MYOCARDIAL METABOLISM

这个子项目是众多研究子项目之一

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Obesity affects more than 43 million Americans and is associated with an increased incidence of heart failure, sudden death, and cardiovascular death. We have shown that increasing obesity, as measured by body mass index (BMI), is independently associated with LV structural and functional changes, specifically, concentric LV remodeling and decreased load-independent measures of diastolic and systolic function and decreased oxygen efficiency (a hallmark of heart failure). Furthermore, we have shown that the insulin resistance that often accompanies obesity in independently related measures of myocardial free fatty acid (FFA) metabolism uptake (MFAUp), utilization (MFAU), and oxidation (MFAO). Moreover, there are data from animal studies and preliminary human studies that demonstrate that excessive myocardial fatty acid metabolism is linked to detrimental myocardial structural changes and may directly contribute to LV dysfunction. In order to increase our understanding of these relationships between BMI or insulin resistance and myocardial metabolism, efficiency, structure, and function in humans, we propose to study the effect of gastric bypass-induced weight loss and consequent improvement in insulin resistance on theses myocardial variables. We further propose to determine how the expected changes in myocardial fatty acid metabolism relate to changes in total body FFA kinetics and delivery.