Bariatric surgeries and cardiac structure and function: Systematic review and network meta-analysis

Area of Science:

• Cardiology
• Metabolic Surgery
• Obesity Medicine

Background:

• Obesity is a major risk factor for cardiovascular disease.
• Bariatric surgery is an effective obesity treatment, but its cardiac effects vary.
• Understanding the impact of different bariatric procedures on heart health is crucial.

Purpose of the Study:

• To systematically review and perform a network meta-analysis on the effectiveness of bariatric surgeries on cardiac structure and function.
• To compare the effects of various bariatric procedures against each other and non-surgical interventions.

Main Methods:

• A systematic search of PubMed, Web of Science, and EMBASE databases was conducted.
• Included studies compared bariatric surgeries with controls or other surgical methods.
• Outcomes assessed included changes in left ventricular mass (LVM), left ventricular mass index (LVMI), and left ventricular ejection fraction (LVEF).

Main Results:

• Gastric bypass significantly reduced LVM and LVMI compared to other bariatric surgeries.
• No significant improvements in left ventricular ejection fraction (LVEF) were observed across any bariatric surgery type.
• Biliopancreatic diversion with duodenal switch resulted in the most substantial reduction in body mass index.

Conclusions:

• Gastric bypass demonstrates superior effectiveness in improving cardiac structure among bariatric surgeries.
• Current evidence does not support significant improvements in cardiac function (LVEF) with any bariatric surgery.
• Further research is needed to elucidate the mechanisms behind these differential effects on cardiac structure and function.