Effects of Weight Loss on Echocardiographic Parameters 1 Year after Sleeve Gastrectomy
Background: Bariatric surgery is efficiently associated with the long-term resolution of obesity and its related morbidities. Not only can this surgical modality improve the metabolic profile, diastolic and systolic cardiac functions, and the clinical symptoms of heart failure or cardiomyopathy, but it can also reduce the atherosclerosis risk, ventricular mass, and pericardial fat thickness. The aim of the present study was to evaluate the effects of weight loss on echocardiographic parameters 1 year after sleeve gastrectomy.
Methods: This quasi-experimental study, conducted in Modarres Hospital, Tehran, Iran, from September 2016 to September 2017, recruited 101 patients. Those with morbid obesity (body mass index ≥40 kg/m2) had undergone surgery 1 year before the study commencement. All the patients underwent sleeve gastrectomy. The data of echocardiographic indices before and 1 year after surgery were recorded and analyzed.
Results: The mean age of the participants was 37.11±9.81 years. The majority of the study participants were female (n=77, 76.2%). During the first postoperative year, the mean weight loss was 43.82±14.53 kg. The mean systolic blood pressure was 137.96±19.60 mmHg and 123.37±9.60 mmHg before sleeve gastrectomy and 1 year afterward, respectively (P<0.001). The mean left ventricular size was 48.22±4.04 mm and 44.97±5.70 mm before sleeve gastrectomy and 1 year postoperatively, correspondingly (P<0.001). The mean pulmonary artery pressure was 28.88±5.25 mmHg and 24.10±4.78 mmHg before sleeve gastrectomy and 1 year after surgery, respectively (P<0.001). The mean left atrial size was 35.72±3.32 mm and 33.12±3.52 mm before sleeve gastrectomy and 1 year thereafter, correspondingly (P<0.001).
Conclusion: Weight loss resulting from sleeve gastrectomy may improve systolic blood pressure, left atrial and left ventricular size, and pulmonary artery pressure.
Bastien M, Poirier P, Lemieux I, Després J-P. (2014) Overview of epidemiology and contribution of obesity to cardiovascular disease. Progress in cardiovascular diseases 56(4):369-81.
Flegal KM, Carroll MD, Kit BK, Ogden CL. (2012) Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. Jama 307(5):491-7.
Ayatollahi S, Ghoreshizadeh Z. (2010) Prevalence of obesity and overweight among adults in Iran. Obesity reviews 11(5):335-7.
Jafari-Adli S, Jouyandeh Z, Qorbani M, Soroush A, Larijani B, Hasani-Ranjbar S. (2014) Prevalence of obesity and overweight in adults and children in Iran; a systematic review. Journal of Diabetes & Metabolic Disorders 13(1):121.
Hinojosa MW, Varela JE, Smith BR, Che F, Nguyen NT. (2009) Resolution of systemic hypertension after laparoscopic gastric bypass. Journal of Gastrointestinal Surgery 13(4):793-7.
Gentileschi P. (2012) Laparoscopic sleeve gastrectomy as a primary operation for morbid obesity: experience with 200 patients. Gastroenterology research and practice 2012.
Chang S-H, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. (2014) The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA surgery 149(3):275-87.
Kehagias I, Zygomalas A, Karavias D, Karamanakos S. (2016) Sleeve gastrectomy: have we finally found the holy grail of bariatric surgery? A review of the literature. Eur Rev Med Pharmacol Sci 20(23):4930-42.
Held M, Mittnacht M, Kolb M, Karl S, Jany B. (2014) Pulmonary and cardiac function in asymptomatic obese subjects and changes following a structured weight reduction program: a prospective observational study. PloS one 9(9):e107480.
Kokkinos A, Alexiadou K, Liaskos C, Argyrakopoulou G, Balla I, Tentolouris N, et al. (2013) Improvement in cardiovascular indices after Roux-en-Y gastric bypass or sleeve gastrectomy for morbid obesity. Obesity surgery 23(1):31-8.
Flores L, Vidal J, Canivell S, Delgado S, Lacy A, Esmatjes E. (2014) Hypertension remission 1 year after bariatric surgery: predictive factors. Surgery for Obesity and Related Diseases 10(4):661-5.
Puri K, Suresh K, Gogtay N, Thatte U. (2009) Declaration of Helsinki, 2008: implications for stakeholders in research. Journal of postgraduate medicine 55(2):131.
Alamdari NM, Bakhtiyari M, Gholizadeh B, Shariati C. (2018) Analgesic Effect of Intraperitoneal Bupivacaine Hydrochloride After Laparoscopic Sleeve Gastrectomy: a Randomized Clinical Trial. Journal of Gastrointestinal Surgery:1-6.
Cavarretta E, Casella G, Calì B, Dammaro C, Biondi-Zoccai G, Iossa A, et al. (2013) Cardiac remodeling in obese patients after laparoscopic sleeve gastrectomy. World journal of surgery 37(3):565-72.
Clarke R. Long-term weight loss and prevention of cardiovascular disease. Am Heart Assoc; 2011.
Himeno E, Nishino K, Nakashima Y, Kuroiwa A, Ikeda M. (1996) Weight reduction regresses left ventricular mass regardless of blood pressure level in obese subjects. American heart journal 131(2):313-9.
Wong CY, O’Moore-Sullivan T, Leano R, Byrne N, Beller E, Marwick TH. (2004) Alterations of left ventricular myocardial characteristics associated with obesity. Circulation 110(19):3081-7.
Algahim MF, Lux TR, Leichman JG, Boyer AF, Miller CC, Laing ST, et al. (2010) Progressive regression of left ventricular hypertrophy two years after bariatric surgery. The American journal of medicine 123(6):549-55.
Fredheim JM, Rollheim J, Sandbu R, Hofsø D, Omland T, Røislien J, et al. (2013) Obstructive sleep apnea after weight loss: a clinical trial comparing gastric bypass and intensive lifestyle intervention. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 9(5):427.
Lauer MS, Anderson KM, Kannel WB, Levy D. (1991) The impact of obesity on left ventricular mass and geometry: the Framingham Heart Study. Jama 266(2):231-6.
Ayer JG, Almafragy HS, Patel AA, Hellyer RL, Celermajer DS. (2008) Body mass index is an independent determinant of left atrial size. Heart, Lung and Circulation 17(1):19-24.
Lauer MS, Anderson KM, Levy D. (1992) Separate and joint influences of obesity and mild hypertension on left ventricular mass and geometry: the Framingham Heart Study. Journal of the American College of Cardiology 19(1):130-4.
|Issue||Vol 14 No 3 (2019): J Teh Univ Heart Ctr|
|Bariatric surgery Echocardiography Gastrectomy|
|Rights and permissions|
|This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.|