Metabolic surgery cuts diuretic dependence in heart failure patients

Pennington Biomedical Research Center researchers at the Metamor Institute, along with colleagues from Our Lady of the Lake and LSU Health-New Orleans, have recently determined that metabolic surgery on patients with heart failure can result in a reduction in the need for oral diuretics, which are used to manage symptoms such as venous and vascular pressures. The researchers explain their processes and further elaborated on their findings in the recent study "Clinical Outcomes of Metabolic Surgery on Diuretic Use in Patients with Heart Failure." 

While obesity is widely recognized as a co-morbidity of heart failure, strong evidence suggests that obesity is a leading cause of the condition. The authors hypothesized that metabolic surgery may reduce recurrence of heart failure symptoms. Researchers reviewed more than 2,300 hospital records of patients who underwent metabolic surgery between 2017 and 2023 and identified 63 of those patients with a diagnosis of heart failure prior to surgery. 

The data unearthed in our study further expands the extended benefits of metabolic surgery, including for those with heart failure and heart disease. With obesity as a commonly occurring factor in heart failure, the reduction in the use of diuretics following metabolic surgery aligns with similar studies on improvements in post-surgery quality of life. The Metamor Institute and Pennington Biomedical investigative teams are pleased to undertake research that provides further clarity into the benefits of obesity interventions." 

Dr. Philip Schauer, Director of the Metamor Institute, Pennington Biomedical Research Center in Baton Rouge, and one of the researchers on the study

The data in the study showed that for patients with heart failure who underwent metabolic surgery, patients saw a mean weight loss of 29 percent 24 months after the surgery. Furthermore, the weight loss was accompanied by a 65 percent decrease in diuretic use at 24 months after surgery. 

"With the high incidence of heart failure and obesity in South Louisiana ongoing research like this is vital to stem the consequences of these diseases and improve the quality of life for our patients." said Dr. Denzil Moraes, FACC and Chief Medical Director of the Heart and Vascular Institute at Our Lady of the Lake Regional Medical Center and co-lead author of the study. 

Researchers relied on the use or disuse of diuretics as markers of whether or not the patients with a history of heart failure continued to use the diuretics to treat heart failure induced water build up. Diuretics, also known as "water pills," are used to enhance kidney function and aid the organ in its role of ridding the body of unneeded water and salt. The removal of this water and salt makes it easier for the heart to pump. As heart failure is associated with high blood pressure, swelling and water build up, diuretics are frequently prescribed to mitigate these issues. 

"While there are obvious benefits to metabolic intervention, I am proud that our team continues to affirm the safety of metabolic surgery, elaborate on its effectiveness and add to the long list of benefits such interventions provide," said Dr. John Kirwan, Executive Director of Pennington Biomedical. "It is research like this that sets Metamor apart and positions the Institute as a leader in the advanced treatment of obesity and diabetes." 

Established in late 2019, the Metamor Institute is a partnership among Pennington Biomedical Research Center, Our Lady of the Lake Regional Medical Center, the Office of the Governor of Louisiana, Louisiana Economic Development, LSU Health New Orleans School of Medicine, and the Pennington Biomedical Research Foundation. The institute is uniquely focused on the treatment of obesity and diabetes. It is the first institute in the nation to offer an integrated and multidisciplinary approach to caring for those suffering from obesity, diabetes and their related diseases in one facility.