Abstract
BACKGROUND: the implication of obessity on cardiometabolic risk factors and incident diabetes has been previously demonstrated, but the impact of weight changes on cardiac structure independent of obesity-related comorbidities has not been extensively studied AIM: to study impact of obesity and surgical weight reduction on cardiac structure. PATIENTS AND METHODS: fifty two patients withbody mass index (BMI) ≥40kg/m(2), free of previous or overt cardiac risk factors and diseases were included, all patients underwent bariatric surgery; Conventional echocardiography (2D, M-Mode, Doppler), tissue Doppler velocity (TDI), strain and speckle tracking echocardiography for left and right ventricles were performed before and 6m after surgery. RESULTS: mean age was 38.2±5.6, BMI 42.3±3.4kg/m(2), 65% were female and 35% were male. 6 months postopeatively; there was significant increase of left ventricular end systolic volume (LVESV) and left ventricular end diastolic volume (LVEDV) from 66.57±22 to 37.2±12 p<0.001, and 169.4±43.2 to 120.36±19.6ml with p<0.001 respectively and increased ejection fraction (EF%) from 59±8 to 67±7ml p<0.001, significant reduction in left ventricular mass index (LVMI) from 143±11 to 95.5±7gm/m(2) p<0.001. Significant increase in right ventricular systolic area (RVSA) from 16.3±4.1 to 10.1±2.7cm(2) p<0.001 but was insignificant in right ventricular diastolic area (RVDA) from 30.2±1.5 to 26.7±2cm(2) p=0.05, fraction area change (FAC) from 49.5±2.1 to 52±1.2% p=0.7, Tricuspid annular plane systolic exertion (TAPSE) from 20.3±2.8to22.6±3.5mm, p=0.56and pulmonary arterty systolic pressure (PASP) from 32.2±5.2 to 29.2±2.1mmHg, p=0.81.Early tissue Doppler diastolic velocity (Em) of the LV increased from 7.1±2.1 to12±3.5 p<0.001 and that of RV from 6.2±2.8 to 9.2±1.4, p=0.05 and tissue Doppler strain of the LV and RV invrased from -16.1±2.5 to -22.8±3.1, p<0.001, -11.2± 2.6 to -17.3±3.4, p<0.001 respectively. Left ventricular longtiduinal systolic strain (LVLPSS) increased from -17.2±2.1 to -22.7±3.9 p<0.001 and right ventricular longtiduinal systolic strain (RVLPSS) increased from -12.8±1.5 to -18.1±2.7 p<0.001. CONCLUSION: Obesity adversely affects cardiac function independent of obesity-related comorbidities .Weight reduction significantly increase the systolic and diastolic function of both ventricles.