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Related Concept Videos

Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...

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Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
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Differential Biventricular Strain Recovery With Selective Fibrosis Biomarker Regression After Sleeve Gastrectomy: A

Harun Akarsu1, İsmail Doğu Kılıç2, Yavuz Dodurga3

  • 1Department of Cardiology, Pamukkale University, Denizli, Turkey. harun.akarsu1@hotmail.com.

Obesity Surgery
|July 13, 2026
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Bariatric surgery improves heart structure and function, but recovery is uneven. Left ventricular mechanics improve, while right ventricular changes suggest afterload reduction, not intrinsic recovery.

Keywords:
Cardiac magnetic resonance feature trackingEndotrophinGalectin-3Laparoscopic sleeve gastrectomyMyocardial strainObesity cardiomyopathy

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Published on: July 20, 2022

Area of Science:

  • Cardiology
  • Metabolic Surgery
  • Cardiovascular Imaging

Background:

  • Obesity-induced cardiac injury involves hemodynamic, fibrotic, and adipokine pathways.
  • The timeline of cardiac recovery after bariatric surgery is not well understood.
  • Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure.

Purpose of the Study:

  • To assess cardiovascular magnetic resonance feature-tracking (CMR-FT), fibrosis, adipokine biomarkers, cardiovascular risk, and quality of life after LSG.
  • To determine if cardiac recovery after LSG is uniform or occurs on different timelines.
  • To investigate the impact of LSG on biventricular and biatrial function.

Main Methods:

  • Prospective cohort study of 32 patients undergoing LSG.
  • Paired cardiovascular magnetic resonance imaging (CMR) before and after LSG (median 8.4 months).
  • Assessment included biventricular/biatrial CMR-FT, fibrosis biomarkers (galectin-3, endotrophin), adipokines (FABP4, apelin, adiponectin), cardiovascular risk scores, and quality of life (SF-36).

Main Results:

  • Significant reduction in left ventricular mass and improved left ventricular longitudinal strain (LVGLS), mid-systolic anterior motion of the pulmonary valve annulus (MAPSE), and ejection fraction (LVEF).
  • Right ventricular ejection fraction (RVEF) increased, but without parallel improvement in right ventricular longitudinal strain (RVGLS) or tricuspid annular plane systolic excursion (TAPSE).
  • Declines in fibrosis biomarkers (galectin-3, endotrophin) but static adipokines; NT-proBNP increased despite improved hemodynamics. Broad improvements in metabolic risk factors and quality of life.

Conclusions:

  • Cardiac reverse remodeling after LSG is measurable within the first year but is uneven.
  • Left ventricular improvements are linked to mass regression and improved longitudinal mechanics.
  • Right ventricular changes suggest afterload reduction rather than intrinsic recovery; distinct timelines exist for fibrosis and adipokine markers.