Effects of Laparoscopic Sleeve Gastrectomy on Cardiac Structure and Function in Obese Patients With Heart Failure.
10.3881/j.issn.1000-503X.16179
- Author:
Xiao-Yan JIA
1
;
Rui-Jia LIAN
2
;
Bao-Dong MA
3
;
Yang-Xi HU
4
;
Qin-Jun CHU
5
;
Hai-Yun JING
6
;
Zhi-Qiang KANG
7
;
Jian-Ping YE
8
;
Xi-Wen MA
9
Author Information
1. Department of Medical Record Management,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
2. The First Clinical Medical College of Xinxiang Medical College,Xinxiang,Henan 453003,China.
3. Department of Trauma Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
4. Department of Metabolic Bariatric Surgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
5. Department of Anesthesiology, Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
6. Department of Cardiovascular Medicine, Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
7. Department of Endocrinology and Metabolism, Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
8. Advanced Medical Center, Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
9. Department of Geriatrics,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,China.
- Publication Type:Journal Article
- Keywords:
cardiac function;
cardiac structure;
heart failure;
laparoscopic sleeve gastrectomy;
obesity
- MeSH:
Humans;
Male;
Female;
Gastrectomy/methods*;
Heart Failure/complications*;
Adult;
Obesity/physiopathology*;
Laparoscopy;
Middle Aged;
Heart/physiopathology*;
Stroke Volume
- From:
Acta Academiae Medicinae Sinicae
2025;47(2):226-236
- CountryChina
- Language:English
-
Abstract:
Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(n=17),a HF with mildly reduced ejection fraction group(n=5)and a HF with reduced ejection fraction(HFrEF)group(n=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples t-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m2.The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(P=0.002),body surface area(BSA)(P=0.009),waist circumference(P=0.010),hip circumference(P=0.031),body fat content(P=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(P<0.001)decreased.At the 12-month follow-up left atrial diameter(P=0.006),right atrial long-axis inner diameter(RAD1)(P<0.001),right atrial short-axis inner diameter(RAD2)(P<0.001),right ventricular inner diameter(P=0.002),interventricular septal thickness at end-diastolic(P=0.002),and left ventricular end-diastolic volumes(P=0.004)and left ventricular end-systolic volumes(P=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both P<0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(P=0.003),left ventricular inner diameter at end-diastole(P=0.008),RAD1(P<0.001),RAD2(P=0.004),right ventricular inner diameter(P=0.019),left ventricular end-diastolic volume(P=0.004)and left ventricular end-systolic volume(P=0.001),cardiac output(P=0.006),tricuspid regurgitation velocity(P=0.002),and pulmonary artery systolic pressure(P=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(P<0.001,P=0.003,P<0.001)and LVEF(P<0.001,P=0.011,P=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.
