Impact of ponderal loss after bariatric surgery on the cardiac structure and function

Abstract

Introduction and objectiveExcess weight can cause structural and functional cardiac disorders. The presence of left ventricular hypertrophy in the obese patient is an independent predictor of cardiovascular morbidity and mortality.The major aim of the present study is to know the prevalence of cardiac morphofunctional disorders in obese patients, before and after weight loss due to bariatric surgery (BS). Patients and methodsProspective cohort study of 75 patients with obesity without known heart disease referred to gastric bypass. Anthropometric, analytical and echocardiographic parameters were measured before and after 6 and 12 months after BS. ResultsThe study included 75 patients (66.6% women, mean age 39.3 (9.7) years and BMI 47.8 (7.1) kg/m2). At 6 and 12 months after BS there was a significant reduction in body weight and an improvement in metabolic, inflammatory and prothrombotic parameters and in cardiovascular risk factors associated with obesity (hypertension, type 2 diabetes, dyslipidemia and obstructive sleep apnea-hypopnea syndrome).Before surgery, cardiac remodelling was present in 62.7%, most frequently in the form of concentric remodelling (38.7%). Diastolic dysfunction occurred in 50.7% of the patients.One year after surgery, the ventricular pattern was normal in 92% of cases and the diastolic function improved significantly. ConclusionsOur results support the negative effect of obesity on cardiac geometry and function and the potential reversibility of these cardiac alterations after marked weight loss due to BS.