Early Effects of Bariatric Surgery on Reversing Obesity-Induced Heart Dysfunction

Severe obesity causes hemodynamic changes in the circulatory system and may lead to heart failure. Weight loss achieved with bariatric surgery can reverse many of the hemodynamic and structural abnormalities caused by obesity. In 39 consecutive patients undergoing bariatric surgery, echocardiographic examinations were performed before surgery and 3 and 6 months after surgery. Detailed echocardiographic parameters assessing the function of the left atrium (LA) and the left (LV) and right ventricle (RV) were analyzed. The study population consisted of 76% women with mean body mass index (BMI) of 40.3 kg/m2 and mean age of 42.4 years. At 3- and 6-month follow-up after bariatric surgery there was a reduction in LV mass (109.7 vs. 99.1 vs. 87.4 kg/m2; p < 0.001), LV end diastolic volume (47.1 vs. 30.0 vs. 43.7; p < 0.001) and stroke volume (29.7 vs. 24.3 vs. 26.3; p = 0.05). Simultaneously an improvement in global longituginal strain (-14.38 vs. -16.79 vs. -18.01) and an increase in LA strain parameters (reservoir : 22.5 vs. 28.0 vs. 31.1; p < 0.001 and conduit: -12.8 vs. -16.5 vs. -19.6) were observed. Comparison of RV parameters before and after bariatric surgery showed improvement in global strain of RV (-15.9 vs. -18.8 vs. -18.38%; p = 0.005), free wall strain (-18.38 vs. -19.70 vs. -19.50; p = 0.042) and reduction in tricuspid regurgitation velocity (1.84 vs. 1.67 vs. 1.46±0.52; p = 0.01). Weight loss contributes to rapid improvement in LA, LV and RV function. New echocardiographic parameters earlier detect subclinical hemodynamic changes associated with obesity and weight loss after bariatric surgery. Obesity contributes to heart dysfunction detected by echocardiography. New echocardiographic techniques enable early detection of deterioration of left atrial, left and right ventricular function in obese patients. Weight loss after bariatric surgery results in rapid improvement in left atrial, left and right ventricular function.