Effect of weight loss after weight loss surgery on plasma N-terminal pro-B-type natriuretic peptide levels

Annabel Chen-Tournoux, Abigail May Khan, Aaron L. Baggish, Victor M. Castro, Marc J. Semigran, Elizabeth L. McCabe, George Moukarbel, Jason Reingold, Sofia Durrani, Gregory D. Lewis, Christopher Newton-Cheh, Marielle Scherrer-Crosbie, Lee M. Kaplan, Thomas J. Wang

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Natriuretic peptides have multiple beneficial cardiovascular effects. Previous cross-sectional studies have indicated that obese subjects have lower natriuretic peptide concentrations than those of normal weight. It is not known whether this relative natriuretic peptide deficiency is reversible with weight loss. We studied 132 obese subjects undergoing weight loss surgery with serial measurement of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations at preoperative, early (1 to 2 months), and late postoperative (6 months) points. In addition, 20 subjects also underwent echocardiography at baseline and 6 months after surgery. Significant weight loss was observed after surgery (median body mass index 45.1, 41.0, and 32.9 kg/m2 for the 3 corresponding points, analysis of variance p <0.001). The median NT-proBNP levels increased substantially (31.6, 66.9, and 84.9 pg/ml; p <0.001). The average intrasubject increase in NT-proBNP at the 2 postoperative points was 3.4 and 5.0 times the preoperative level (p <0.001 for both points vs preoperatively). In the multivariate regression models adjusted for clinical characteristics and insulin resistance, the strongest predictor of the change in NT-proBNP level 6 months after weight loss surgery was the change in weight (p = 0.03). Echocardiography showed a mean intrasubject reduction in left ventricular mass index of 18% (p <0.001) and mild improvements in diastolic function, with no change in ejection fraction. In conclusion, we have demonstrated that weight loss is associated with early and sustained increases in NT-proBNP concentrations, despite evidence of preserved systolic and improved diastolic function. These findings suggest a direct, reversible relation between obesity and reduced natriuretic peptide levels.

Original languageEnglish (US)
Pages (from-to)1450-1455
Number of pages6
JournalAmerican Journal of Cardiology
Issue number10
StatePublished - Nov 15 2010
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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