dc.description.abstract | Obesity and associated comorbidities reach epidemic proportions nowadays. Several treatment strategies exist, but bariat-ric surgery has the only longstanding effects. Since a few years, there is increasing interest in the effects of gastro-intesti-nal hormones, in particular Glucagon-Like Peptide-1 (GLP-1) on the remission of Type 2 Diabetes (T2DM) and its effects on cardiac cardiovascular morbidity, cardiac remodeling, and mortality. In the past years several high quality multicenter randomized controlled trials were developed to assess the effects of GLP-1 receptor agonist therapy on cardiovascular morbidity and mortality. Most of the trials were designed and powered as non-inferiority trials to demonstrate cardiovas-cular safety. Most of these trials show a reduction in cardiovascular morbidity in patients with T2DM. Some follow-up studies indicate potential beneficial effects of GLP-1 receptor agonists on cardiovascular function in patients with heart failure, however the results are contradictory, and we need long-term studies to make firm conclusions about the pleio-tropic properties of incretin-based therapies. However, it seems that GLP-1 receptor agonists have different effects than the increased GLP-1 production after bariatric surgery on cardiovascular remodeling. One of the hypotheses is that the blood concentrations of GLP-1 receptor agonists are three times higher compared to GLP-1 increase after bariatric and metabolic surgery. The purpose of this narrative review is to summarize the effects of GLP-1 on cardiovascular morbidity, mortality and remodeling due to medication but also due to bariatric and metabolic surgery. The second objective is to explain the possible differences in effects of GLP-1 agonists and bariatric and metabolic surgery. | en_US |
dc.department-temp | [Timmermans, Marieke; Sanches, Elijah E.] Haaglanden Med Ctr, Dept Surg, The Hague, Netherlands; [Topal, Besir] Onze Lieve Vrouw Hosp, Dept Cardiothorac Surg, Amsterdam, Netherlands; [De Jongh, Frank W.] Haaglanden Med Ctr, Dept Plast Surg, The Hague, Netherlands; [Cagiltay, Eylem] Istanbul Bilim Univ, Sch Med, Dept Physiol, Istanbul, Turkey; [Celik, Alper] Metab Surg Clin, Istanbul, Turkey; [Ribeiro, Rui] St Antonio Clin, Multidisciplinary Ctr Metab Dis, Amadora, Portugal; [Parmar, Chetan] Whittington Hosp, Dept Surg, London, England; [Ugale, Surendra] Virinchi Hosp, Bariatr & Metab Surg Clin, Hyderabad, India; [Proczko, Monika] Gdansk Univ, Univ Med Ctr, Dept Gen Endocrine & Transplant Surg, Gdansk, Poland; [Stepaniak, Pieter S.] Noordwest Hosp Grp, Dept Hlth Operat Management, Alkmaar, Netherlands; [Buise, Marc P.] Catharina Hosp, Dept Anesthesiol Intens Care & Pain Med, Eindhoven, Netherlands; [Severin, Rich] Univ Illinois, Coll Appl Hlth Sci, Dept Phys Therapy, Chicago, IL USA; [Severin, Rich] Baylor Univ, Robbins Coll Hlth & Human Sci, Phys Therapy Program, Waco, TX USA; [Pouwels, Sjaak] Elisabeth Tweesteden Hosp, Dept Intens Care Med, Hilvarenbeekseweg 60, NL-5000 Tilburg, Netherlands | en_US |