Long-Term Trajectories of Left Heart Geometry, Mechanics, and Oxygen Demand After Bariatric Surgery.

IF 7.8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation: Heart Failure Pub Date : 2025-04-07 DOI:10.1161/CIRCHEARTFAILURE.124.012367

Lisa M D Grymyr, Saied Nadirpour, Eva Gerdts, Bjørn G Nedrebø, Knut Matre, Dana Cramariuc

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引用次数: 0

Abstract

Background: The long-term impact of bariatric surgery on cardiac mechanics and energetics has been scarcely documented. We aimed to assess prospectively the 5-year trajectories of left heart geometry, mechanics, and myocardial oxygen (O₂) demand after bariatric surgery.

Methods: In the Bariatric Surgery on the West Coast of Norway study, left ventricular (LV) and atrial remodeling was evaluated preoperatively, 6 months, and 1 and 5 years after Roux-en-Y gastric bypass in 102 patients. LV geometry was assessed by the LV mass/height^2.7 and the relative wall thickness, and mechanics by the global longitudinal strain and the midwall shortening. LV myocardial O₂ demand was estimated from the product LV mass×wall stress×heart rate. The left atrial reservoir function was measured by the emptying fraction.

Results: After 63 (interquartile range, 62-66) months, LV mass index, global longitudinal strain, myocardial oxygen demand, and left atrial emptying fraction were improved (P<0.001) while midwall shortening did not change significantly. Prevalence of normal LV geometry increased from 61% to 82%. In linear mixed-effects models with adjustment for clinical characteristics, improving global longitudinal strain and myocardial O₂ demand over time were associated with female sex and lower body mass index (P<0.05). In logistic regression analysis, 5-year presence of abnormal LV geometry, low LV global longitudinal strain, or high myocardial O₂ demand was related to preoperative diabetes, hypertension, and higher body mass index, as well as higher 5-year systolic blood pressure (P<0.05; Nagelkerke R²=0.40).

Conclusions: Bariatric surgery results in favorable 5-year trajectories of LV geometry, myocardial O₂ demand, and left heart longitudinal mechanics. However, suboptimal postoperative body mass index and blood pressure control promote long-term LV structural disease.

Registration: URL: https://www.clinicaltrials.gov; Unique identifier:: NCT01533142.

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来源期刊

Circulation: Heart Failure 医学-心血管系统

CiteScore

12.90

自引率

3.10%

发文量

271

审稿时长

6-12 weeks

期刊介绍： Circulation: Heart Failure focuses on content related to heart failure, mechanical circulatory support, and heart transplant science and medicine. It considers studies conducted in humans or analyses of human data, as well as preclinical studies with direct clinical correlation or relevance. While primarily a clinical journal, it may publish novel basic and preclinical studies that significantly advance the field of heart failure.