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Effect of bariatric surgery on cardiac function in obese patients: An echocardiographic assessment
Mansur S Alqunai1, Bandar S Assakran1, Adel M Widyan1
1From the Department of Surgery (Alqunai, Assakran, Alharbi, Alromaih), King Fahad Specialist Hospital, Ministry of Health, Buraidah, Qassim; from the Department of Mathematics (Widyan), College of Science, from the Department of Surgery (Almosallam, Alotaibi), College of Medicine, Qassim University; from the Department of Non-invasive Cardiology (Suresh), Prince Sultan Cardiac Center; from the Department of Surgery (Alashkar), Doctor Sulaiman AlHabib Medical Group, Qassim; from the Department of Surgery (Alqunai), College of Medicine, Jouf University, Aljouf, Kingdom of Saudi Arabia; and from the Division of Cardiology (Abazid), London Health Sciences Centre, University Hospital, Ontario, Canada.
Objectives:
To analyze the clinical and echocardiographic changes in individuals with morbid obesity who underwent bariatric surgery.
Methods:
In total, 59 obese patients with body mass index >35 kg/m2 were prospectively enrolled. We assessed baseline pre-operative and a 6-month post-operative lipid profile, hemoglobin A1c, echocardiography, lifetime, and a 10-year risks of atherosclerotic disease for all patients.
Results:
The mean patients' age was 37±12 years, with 40 (67.8%) women. We found that the pre-operative total cholesterol (4.2±1.1 vs. 4.4±1.1, p=0.014) and triglyceride levels (1.4±0.7 vs. 1.8±0.8, p<0.0001) were significantly lower than post-operative levels, while post-operative high-density lipoprotein levels were significantly higher (1.5±0.5 vs. 1.2±0.3, p<0.0001). The calculated 10-year risk of atherosclerotic cardiovascular disease was significantly lower post-operatively (1.1±1.6% vs. 1.6±1.8%, p<0.0001). Echocardiography follow-up revealed that diastolic dysfunction was more prevalent pre-operatively than that post-operatively (41% vs. 10%, p<0.0001). Post-operative left ventricular (LV) mass was significantly lesser than the pre-operative mass (168±252 g vs. 187±255 g, p=0.019), whereas the post-operative LV diastolic (46.5±7 mm vs. 38.5±18 mm, p=0.002) and systolic dimensions (31±5 mm vs. 25±11 mm, p=0.001) were significantly smaller.
Conclusion:
Bariatric surgery resulted in a significant amelioration in lipid profile, reduction in LV mass, and LV cavity dimensions.
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