The effect of significant weight loss after bariatric surgery on echocardiographic indices: an observational study focusing on left ventricular deformation by 2D speckle echocardiography and right ventricular size

Saeed Safari, Mozhgan Parsaee, Mohammad Moradi, Mahdi Hakiminejad, Parisa Koohsari, Farnoosh Larti
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Abstract

Obesity is a known risk factor for atherosclerosis and cardiac disease. This study evaluated the effect of significant weight loss following bariatric surgery on myocardial deformation indices and right ventricular size (RV). This was a prospective cohort study. Morbid obese patients scheduled for bariatric surgery from July 2017 to February 2018 at Firoozgar Hospital were included in our study and referred for transthoracic echocardiography at Rajaie Cardiovascular Medical and Research Center. Thirty-four patients entered the study. The absolute value of global longitudinal strain (GLS) at baseline, 3, and 6 months after surgery was 17.42 ± 2.94%, 18.24 ± 3.09%, and 19.52 ± 2.78%, respectively, with a statistically significant difference from baseline to after six months (P value < 0.001). The absolute value of global circumferential strain (GCS) at baseline, 3, and 6 months after surgery was 20.14 ± 4.22%, 23.32 ± 4.66%, and 24.53 ± 4.52%, respectively, with statistically significant changes (P value < 0.001) from baseline to three months and from baseline to six months and no significant difference from three months to six months. A significant decrease was reported in mechanical dispersion of circumferential strain (38.05 ± 23.81–23.37 ± 20.86 ms, P value = 0.006) 6 months after surgery. Right ventricular size three- and six-month post-surgery showed a significant decrease relative to baseline echocardiography. Bariatric surgery could enhance cardiac function, as proven by 2D speckle echocardiography. Changes in RV size may be related to weight loss and should be considered when assessing patients who have undergone bariatric surgery.
减肥手术后体重明显减轻对超声心动图指标的影响:一项观察性研究,重点是二维斑点超声心动图显示的左心室变形和右心室大小
众所周知,肥胖是动脉粥样硬化和心脏病的危险因素。本研究评估了减肥手术后体重大幅下降对心肌变形指数和右心室大小(RV)的影响。这是一项前瞻性队列研究。2017年7月至2018年2月期间,计划在菲罗兹加医院接受减肥手术的病态肥胖患者被纳入我们的研究,并转诊至拉杰心血管医疗和研究中心接受经胸超声心动图检查。34 名患者参与了研究。基线、术后 3 个月和 6 个月时的整体纵向应变(GLS)绝对值分别为 17.42 ± 2.94%、18.24 ± 3.09% 和 19.52 ± 2.78%,从基线到 6 个月后的差异具有统计学意义(P 值 < 0.001)。术后基线、3个月和6个月时的全周应变(GCS)绝对值分别为(20.14 ± 4.22%)、(23.32 ± 4.66%)和(24.53 ± 4.52%),从基线到3个月以及从基线到6个月的变化均有统计学意义(P值< 0.001),而从3个月到6个月则无明显差异。术后 6 个月,周向应变的机械分散性(38.05 ± 23.81-23.37 ± 20.86 ms,P 值 = 0.006)明显下降。与基线超声心动图相比,手术后三个月和六个月的右心室大小明显缩小。二维斑点超声心动图证实,减肥手术可增强心脏功能。RV 大小的变化可能与体重减轻有关,因此在评估接受减肥手术的患者时应加以考虑。
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