Thomas E Kaier1, Douglas Morgan1, Julia Grapsa1, Ozan M Demir1, Stavroula A Paschou2, Shweta Sundar1, Sherif Hakky3, Sanjay Purkayastha3, Susan Connolly1, Kevin F Fox1, Ahmed Ahmed3, Jonathan Cousins4, Petros Nihoyannopoulos5. 1. Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK. 2. Department of Diabetes, St Bartholomew's Hospital, London, UK. 3. Department of Bariatric Surgery and Anesthesia, St Mary's Hospital, Imperial College NHS Trust, London, UK. 4. Department of Anaesthesia, Charing Cross Hospital, Imperial College NHS Trust, London, UK. 5. Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK petros@imperial.ac.uk.
Abstract
AIMS: The aim of the study was to examine ventricular remodelling in patients free of cardiac risk factors, before, and 6 months post-bariatric surgery with the new imaging modality of three-dimensional (3D) strain and the comparison of two surgical techniques: sleeve gastrectomy vs. gastric bypass. METHODS AND RESULTS: Fifty-two consecutive patients referred to the Bariatric Services of Imperial College NHS Trust were examined with conventional 2D and 3D strain echocardiography, prior to and 6 months after bariatric surgery. They were all free from cardiac disease. The study cohort's mean age was 44.2 ± 8.7 years and body mass index of 42.4 ± 4.6 g/m(2) prior to surgery. Eighteen patients (34.6%) underwent laparoscopic sleeve gastrectomy, and 34 laparoscopic gastric bypass. On 3D speckle tracking, there was significant reverse remodelling post-bariatric surgery [left ventricular (LV) ejection fraction (EF): pre-surgery: 59 ± 8% vs. post-surgery: 67 ± 7%, P < 0.001 and right ventricular (RV) EF: pre-surgery: 60 ± 9% vs. post-surgery: 68 ± 8.2%, P = 0.0001]. Furthermore, there was significant regression of mass (LV mass: pre-surgery: 111 ± 23.5 g vs. post-surgery: 92.8 ± 15.5 g and RV mass: pre-surgery: 95.2 ± 19.8 vs. post-surgery: 67.3 ± 16.3, P < 0.001). RV and LV global strain improved 6 months post-bariatric surgery: global RV strain: pre-surgery -11.7 ± 4 vs. post-surgery -17.52 ± 3.7, P < 0.001; global LV strain: pre-surgery: -20.2 ± 1.7 vs. post-surgery: -26.5 ± 1.86, P < 0.001. Sleeve gastrectomy and gastric bypass had comparable effects. CONCLUSION: Bariatric surgery has an important effect in reverse LV and RV remodelling and it substantially improves RV longitudinal strain. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: The aim of the study was to examine ventricular remodelling in patients free of cardiac risk factors, before, and 6 months post-bariatric surgery with the new imaging modality of three-dimensional (3D) strain and the comparison of two surgical techniques: sleeve gastrectomy vs. gastric bypass. METHODS AND RESULTS: Fifty-two consecutive patients referred to the Bariatric Services of Imperial College NHS Trust were examined with conventional 2D and 3D strain echocardiography, prior to and 6 months after bariatric surgery. They were all free from cardiac disease. The study cohort's mean age was 44.2 ± 8.7 years and body mass index of 42.4 ± 4.6 g/m(2) prior to surgery. Eighteen patients (34.6%) underwent laparoscopic sleeve gastrectomy, and 34 laparoscopic gastric bypass. On 3D speckle tracking, there was significant reverse remodelling post-bariatric surgery [left ventricular (LV) ejection fraction (EF): pre-surgery: 59 ± 8% vs. post-surgery: 67 ± 7%, P < 0.001 and right ventricular (RV) EF: pre-surgery: 60 ± 9% vs. post-surgery: 68 ± 8.2%, P = 0.0001]. Furthermore, there was significant regression of mass (LV mass: pre-surgery: 111 ± 23.5 g vs. post-surgery: 92.8 ± 15.5 g and RV mass: pre-surgery: 95.2 ± 19.8 vs. post-surgery: 67.3 ± 16.3, P < 0.001). RV and LV global strain improved 6 months post-bariatric surgery: global RV strain: pre-surgery -11.7 ± 4 vs. post-surgery -17.52 ± 3.7, P < 0.001; global LV strain: pre-surgery: -20.2 ± 1.7 vs. post-surgery: -26.5 ± 1.86, P < 0.001. Sleeve gastrectomy and gastric bypass had comparable effects. CONCLUSION: Bariatric surgery has an important effect in reverse LV and RV remodelling and it substantially improves RV longitudinal strain. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Eduardo Cavalcanti Lapa Santos; J M Del Castillo; G B O Parente; R P Pedrosa; P S Gadelha; R D Lopes; F Kreimer; F R M Neto Journal: Obes Surg Date: 2020-02 Impact factor: 4.129