Background: the implication of obessity on cardiometabolic risk factors and incident diabetes has been
previously demonstrated, but the impact of weight changes on cardiac structure independent of obesityrelated
comorbidities has not been extensively studied
Aim: to study impact of obesity and surgical weight reduction on cardiac structure.
Patients and methods:
fifty two patients withbody mass index (BMI)
40 kg/m2, free of previous or overt
cardiac risk factors and diseases were included, all patients underwent bariatric surgery; Conventional
echocardiography (2D, M-Mode, Doppler), tissue Doppler velocity (TDI), strain and speckle tracking
echocardiography for left and right ventricles were performed before and 6 m after surgery.
Results: mean age was 38.2
5.6, BMI 42.3
3.4 kg/m2, 65% were female and 35% were male. 6 months
postopeatively; there was significant increase of left ventricular end systolic volume (LVESV) and left
ventricular end diastolic volume (LVEDV) from 66.57
22 to 37.2
12 p < 0.001, and 169.4
43.2 to
120.36
19.6 ml with p < 0.001 respectively and increased ejection fraction (EF%) from 59
8 to
67
7 ml p < 0.001, significant reduction in left ventricular mass index (LVMI) from 143
11 to
95.5
7gm/m2 p < 0.001. Significant increase in right ventricular systolic area (RVSA) from 16.3
4.1 to
10.1
2.7 cm2 p < 0.001 but was insignificant in right ventricular diastolic area (RVDA) from 30.2
1.5 to
26.7
2 cm2 p = 0.05, fraction area change (FAC) from 49.5
2.1 to 52
1.2% p = 0.7, Tricuspid annular
plane systolic exertion (TAPSE) from 20.3
2.8to22.6
3.5 mm, p = 0.56and pulmonary arterty systolic
pressure (PASP) from 32.2
5.2 to 29.2
2.1 mmHg, p = 0.81.Early tissue Doppler diastolic velocity (Em)
of the LV increased from 7.1
2.1 to12
3.5 p < 0.001 and that of RV from 6.2
2.8 to 9.2
1.4, p = 0.05
and tissue Doppler strain of the LV and RV invrased from
16.1
2.5 to
22.8
3.1, p < 0.001,
11.2
2.6
to
17.3
3.4, p < 0.001 respectively. Left ventricular longtiduinal systolic strain (LVLPSS) increased from
17.2
2.1 to
22.7
3.9 p < 0.001 and right ventricular longtiduinal systolic strain (RVLPSS) increased
from
12.8
1.5 to
18.1
2.7 p < 0.001.
Conclusion: Obesity adversely affects cardiac function independent of obesity-related comorbidities .
Weight reduction significantly increase the systolic and diastolic function of both ventricles.
© 2018 Published by Elsevier B.V. on behalf of Cardiological Society of India. This is an open access article
under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
