RV function in obesity: before and after laparoscopic gastric sleeve

Abstract

Abstract Left ventricular (LV) changes associated with obesity, including LV hypertrophy and impaired LV function, have been shown to be reverted by bariatric surgery. Little is known about the effect of bariatric procedures on right ventricle (RV) function. Aim We analyzed RV functional changes, as assessed by echocardiography, after laparoscopic gastric sleeve (LGS) bariatric surgery. Methods 22 consecutive obese subjects with good acoustic windows (mean age 40.2±6.7 years, 41% men, mean body mass index (BMI) 43.5±6 kg/m2) scheduled for LGS were prospectively studied before and 12 months after surgery. RV function was assessed by RV Fractional Area Change (FAC), TDI RV free wall S wave (RV S) and free wall RV longitudinal strain (LS) and strain rate (L-SR), calculated by 3D speckle tracking echocardiography (STE). The estimated systolic pulmonary artery pressure (sPAP) was evaluated by tricuspid regurgitation velocity. Results Preoperative and postoperative obesity measures, as well as RV function measures significantly improved 12 months postoperatively versus baseline (all p<0.05 vs baseline): BMI decreased from 43.5±2.8 to 30.3±2.9 kg/m2, abdominal circumference from 124.8±4.7 to 98.4±5 cm, RV S changed from 12.8±1.1 to 13.4±1.3 cm/s, FAC from 44.2±3.8 to 52.8±2.8%, 3D LS from 15±1.3% to 17.8±2.2% and 3D L-SR from −1.1±1.4 to −2±0.9 s–1. Patients had similar sPAP before and after surgery. Conclusion By successful weight loss, 12 months after LGS, subclinical RV function parameters improved, in association with favorable metabolic changes. These findings may contribute to the cardioprotective effects of bariatric surgery. Funding Acknowledgement Type of funding source: None