Exercise Enhances the Effect of Bariatric Surgery in Markers of Cardiac Autonomic Function
Open accessAbstract
Background Bariatric surgery improves cardiovascular health, which might be partly ascribed to beneficial alterations in the autonomic nervous system. However, it is currently unknown whether benefits from surgery on cardiac autonomic regulation in post-bariatric patients can be further improved by adjuvant therapies, namely exercise. We investigated the effects of a 6-month exercise training program on cardiac autonomic responses in women undergoing bariatric surgery.Methods Sixty-two women eligible for bariatric surgery were randomly allocated to either standard of care (control) or an exercise training intervention. At baseline (PRE) and 3 (POST3) and 9 (POST9) months after surgery, we assessed chronotropic response to exercise (CR%; i.e., percentage change in heart rate from rest to peak exercise) and heart rate recovery (HRR30s, HRR60s, and HRR120s; i.e., decay of heart rate at 30, 60, and 120 s post exercise) after a maximal exercise test.Results Between-group absolute changes revealed higher CR% (Δ = 8.56%, CI95% 0.22-19.90, P = 0.04), HRR30s (Δ = 12.98 beat/min, CI95% 4.29-21.67, P = 0.01), HRR60s (Δ = 22.95 beat/min, CI95% 11.72-34.18, P = 0.01), and HRR120s (Δ = 34.54 beat/min, CI95% 19.91-49.17, P < 0.01) in the exercised vs. non-exercised group.Conclusions Our findings demonstrate that exercise training enhanced the benefits of bariatric surgery on cardiac autonomic regulation. These results highlight the relevance of exercise training as a treatment for post-bariatric patients, ensuring optimal cardiovascular outcomes.
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Exercise following bariatric surgery may synergistically enhance weight maintenance, glycemic management, and insulin sensitivity, lower risk of cardiovascular disease, enhance endothelial function, and improve cardiac autonomic regulation.
“Exercise following surgery may synergistically enhance weight maintenance, glycemic management, and insulin sensitivity [243], lower the risk of cardiovascular disease, enhance endothelial function, and improve cardiac autonomic regulation [244].”
From Lifestyle Medicine for Obesity in the Era of Highly Effective Anti-Obesity Treatment (2025) · cites this paper as [244]
Citation [244] attaches to the cardiovascular-risk, endothelial-function, and cardiac-autonomic-regulation claims; the weight and glycemic claims are cited to [243]. The Discussion and Conclusion reports improved markers of cardiac autonomic regulation with exercise after bariatric surgery and links those markers to cardiovascular health, but it does not establish a reduction in cardiovascular disease risk. Endothelial function appears only in the title of a cited reference, not as a finding of this paper. (LLM, conf=0.86)
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“Exercise following surgery may synergistically enhance weight maintenance, glycemic management, and insulin sensitivity [243], lower the risk of cardiovascular disease, enhance endothelial function, and improve cardiac autonomic regulation [244].”
- Authors
- Gil, S., Peçanha, T., Dantas, W. S., Murai, I. H., Merege-Filho, C. A. A., de Sá-Pinto, A. L., Pereira, R. M. R., de Cleva, R., Santo, M. A., Rezende, D. A. N., Kirwan, J. P., Gualano, B., & Roschel, H.
- Affiliations
- Universidade de São Paulo (BR)
- Pennington Biomedical Research Center (US)
- Corresponding author
- Roschel, Hamilton
- ORCID
- Venue
- Obesity Surgery
- Published
- 2020-10-27
- Volume
- 31
- Issue
- 3
- Pages
- 1381-1386
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- PMC
- PMC9103249
- OpenAlex
- W3095515738
- Cited by
- 22
- References
- 18
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 5 · 2022: 4 · 2021: 3
- FWCI
- 2.74
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (U54GM104940)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- bariatric surgery, exercise training
- MeSH terms
- Autonomic Nervous System, Exercise Test, Exercise Therapy, Female, Heart, Heart Rate, Humans, Obesity, Morbid, Bariatric Surgery
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