Effects of weight loss after sleeve gastrectomy on left ventricular myocardial work in obese patients.

Abstract

Background: Obesity is a global epidemic and a major risk factor for cardiovascular diseases. Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric surgery, but its effect on cardiac functions remains unclear. This study aims to investigate the impact of weight loss after LSG on the left ventricular myocardial work (LVMW) in obese patients and explore the clinical value of the left ventricular pressure - strain loop (LV - PSL).

Methods: Thirty - eight obese patients (body mass index ≥ 30 kg/m²) were enrolled preoperatively, and 31 patients completed the study after six months of follow - up. Clinical information, parameters from left ventricular myocardial work and traditional two - dimensional strain echocardiography were collected and analyzed.

Results: After LSG, significant reductions in body mass index (BMI), diastolic blood pressure (DBP) and weight were observed. Cardiac output (CO), stroke volume (SV), left ventricular end - diastolic volume (LVEDV), left ventricular end - systolic volume (LVESV), left ventricular ejection fraction (LVEF), Peak E, e', and a' decreased, while left ventricular mass index increased. Myocardial work parameters also showed significant changes after LSG, with global longitudinal strain (GLS) and global work efficiency (GWE) increasing and global work index (GWI), global constructive work (GCW), and global wasted work (GWW) decreasing. Significant correlations were observed between the differences in GWW and left ventricular end - diastolic diameter (LVDd), as well as between the differences in GWI and LVEDV. The differences in left ventricular mass and its index were both significantly negatively correlated with the difference in GWW.

Conclusions: LV - PSL can effectively evaluate left ventricular myocardial work in obese patients. Weight loss after LSG can improve left ventricular myocardial work efficiency, and the associated parameter changes are related to cardiac structure, offering new clinical references.