Impact of surgical and non-surgical weight loss on echocardiographic and strain parameters in Asian patients

Abstract

Objective: Surgical weight loss (SWL) improves myocardial mechanics as measured by speckle-tracking imaging. However non-surgical versus SWL and the subsequent impact on myocardial function in overweight Asian subjects has not been evaluated. Methods: 66 patients underwent a 16-week lifestyle intervention (LSI) programme consisting of dietary interventions and exercise prescription. Echocardiography with speckle tracking was performed at baseline and post-intervention. This group was compared against a group of 12 subjects who had undergone bariatric surgery and a control group of 10 lean Asian subjects. A generalised structural equation model (gSEM) was constructed to ascertain the effect of modality of weight loss on strain parameters, adjusting for BMI. Results: Participants attained significant weight loss after LSI (28.2±2.66 kg/m2 vs 25.8±2.84 kg/m2, p=0.001). This was associated with a non-significant trend towards improvement in strain parameters. SWL participants had significant improvement in the left ventricular global longitudinal strain (-20.52±3.34 vs -16.68±4.15, p<0.01) and left atrium reservoir strain (44.32±14.23 vs 34.3±19.31, p=0.02). Lean subjects had significantly higher strain parameters than overweight subjects. The gSEM model demonstrated surgical modality of weight loss as an independent predictor of improvement in strain parameters. Conclusion: Significant improvement in echocardiographic parameters were documented in patients who underwent bariatric surgery.