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Cardiac Remodeling in Obese Patients After Laparoscopic Sleeve Gastrectomy

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Abstract

Background

Obesity is associated with high morbidity and represents an increasing health care problem worldwide. Laparoscopic sleeve gastrectomy (LSG) has been used effectively for weight loss and co-morbidity remission. In this retrospective study, we evaluated cardiac reverse remodeling at medium-term follow-up by echocardiography, the amount of cardiovascular medications, and the impact of co-morbidities after sleeve gastrectomy.

Methods

Altogether, 16 obese patients (4 men, 12 women; 46.4 ± 10.3 years) underwent complete clinical evaluation, laboratory tests, and color Doppler/tissue Doppler imaging echocardiography preoperatively and 12–20 months after bariatric surgery.

Results

Body weight (mean body mass index) was significantly reduced (from 44.8 ± 8.0 to 31.2 ± 7.8 kg/m2; p = 0.001). Lipid profile significantly improved: total cholesterol and triglycerides decreased (respectively: 215.5 ± 53.8 vs. 205.3 ± 46.6 mg/dl and 184.9 ± 109.3 vs. 116.1 ± 49.9 mg/dl, both p ≤ 0.05), and high-density lipoprotein increased (43.1 ± 10.9 vs. 51.4 ± 12.8 mg/dl, p = 0.005). Systolic blood pressure significantly decreased (from 133.0 ± 17.1 to 120.6 ± 13.7 mmHg; p = 0.04). Diabetes remission was complete in five of six patients (83 %) and sleep apnea in four of five (80 %). Echocardiography showed significantly reduced interventricular septum and posterior wall thickness (11.3 ± 1.8 to 9.4 ± 2.1 mm and 10.4 ± 1.7 to 8.6 ± 1.9 mm, respectively; both p < 0.007) and reduced left ventricular mass (absolute value and indexed by height, respectively: 222.41 ± 78.2 to 172.75 ± 66.3 g (p = 0.003) and 55.9 ± 14.3 to 43.8 ± 17.2 g/m2.7 (p = 0.0004). Antihypertensive drug intake was significantly reduced (p = 0.03), as shown by the 10-year Framingham Risk Score (from 14.2 ± 9.3 to 8.3 ± 9.5 %, p = 0.003).

Conclusions

Sleeve gastrectomy is associated with marked improvement in terms of weight loss, lipid profile, type 2 diabetes, sleep apnea, hypertension, and left ventricular hypertrophy, with a significantly reduced Framingham Risk Score.

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Acknowledgments

This study was supported by Sapienza University of Rome Research Grant and grants from Fondazione Roma. We are grateful to Dr. Isotta Chimenti for her critical reading.

Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Surgical-Medical Department for Digestive Diseases, Policlinico “Umberto I”, “Sapienza” University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Giovanni Casella, Benedetto Calì, Carmelisa Dammaro, Angelo Iossa & Nicola Basso

  2. Department of Medico-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Corso Della Repubblica 79, 04100, Latina, Italy

    Elena Cavarretta, Giuseppe Biondi-Zoccai & Giacomo Frati

  3. Department of Clinical Sciences, Policlinico “Umberto I”, “Sapienza” University of Rome, Viale del Policlinico 155, 00161, Rome, Italy

    Frida Leonetti

  4. Department of Angiocardioneurology, IRCCS Neuromed, 86077, Pozzilli, Isernia, Italy

    Giacomo Frati

Authors
  1. Elena Cavarretta
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  2. Giovanni Casella
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  3. Benedetto Calì
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  4. Carmelisa Dammaro
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  5. Giuseppe Biondi-Zoccai
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  6. Angelo Iossa
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  7. Frida Leonetti
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  8. Giacomo Frati
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  9. Nicola Basso
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Corresponding author

Correspondence to Nicola Basso.

Additional information

Elena Cavarretta and Giovanni Casella contributed equally to this work.

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Cavarretta, E., Casella, G., Calì, B. et al. Cardiac Remodeling in Obese Patients After Laparoscopic Sleeve Gastrectomy. World J Surg 37, 565–572 (2013). https://doi.org/10.1007/s00268-012-1874-8

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  • DOI: https://doi.org/10.1007/s00268-012-1874-8

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