The Effect of Surgical Weight Reduction on Left Ventricular Structure and Function in Severe Obesity

Abstract

The aim of this study was to examine the effect of surgical weight reduction on cardiac structure and function and to seek the determinants of these changes. Sixty‐six severely obese adults (BMI ≥35 kg/m2) who received bariatric surgery underwent echocardiographic examination before and 3 months after surgery. At 3 months after surgery, BMI and systolic blood pressure (BP) decreased (43.3 ± 6.3 to 34.1 ± 5.6 kg/m2, P < 0.001, and 146 ± 12 to 130 ± 14 mm Hg, P < 0.001, respectively). In left ventricular (LV) geometry, the relative wall thickness (RWT) and LV mass index decreased significantly (0.43 ± 0.05 to 0.35 ± 0.05, P < 0.001, and 50 ± 11 to 39 ± 11 g/m2.7, P < 0.001, respectively) without changes in chamber size. Multivariate analyses showed change in systolic BP to be an independent predictor for the changes in RWT and LV mass index. In myocardial performance, peak systolic mitral annular velocity and all diastolic indexes showed significant improvements. We concluded that LV hypertrophy and function improved rapidly after bariatric surgery in severely obese adults. BP reduction was the major determinant for the regression of LV hypertrophy in the early stage of surgical weight reduction.

B-type natriuretic peptide increases after gastric bypass surgery and correlates with weight loss

“…Obesity is known to be associated with cardiac chamber dilation, with marked increases in wall thickness, a process that leads to eccentric LV hypertrophy [15,16]. With echocardiography, Hsuan et al [17] showed that surgical weight reduction significantly reduces relative wall thickness. However, chamber size was not changed 3 months after bariatric surgery.…”

Left-ventricular hypertrophy and obesity

“…Of note, six studies [23,24,30,33,35,36] examined 726 morbid obese individual candidates for bariatric surgery.…”

“…Mean age range was 31-76 years [30,27]; 38.1% of participants were men (n ¼ 1793, data provided by 19 studies including 4749 patients).…”

The Amount of Weight Loss Six Months after Bariatric Surgery: It Makes a Difference

“…Obesity can lead to structural and functional worsening of the cardiovascular and pulmonary system [17, 18], as well as a reduction of the oxidative capacity of skeletal muscles [19]. Cardiopulmonary functional capacity provides diagnostic and prognostic information in a wide variety of clinical settings [20, 21].…”