Key result
Bariatric surgery is linked to a ~6% LVEF improvement and better functional capacity in LV dysfunction.
Why the study?
Obesity and heart failure with left ventricular ejection dysfunction (LVED) are rising worldwide, and the perioperative complications and long-term effectiveness of bariatric surgery in this population needed evaluation.
Does bariatric surgery safely improve left ventricular ejection fraction and functional capacity in patients with severe obesity and left ventricular dysfunction?
Does bariatric surgery safely improve left ventricular ejection fraction and functional capacity in patients with severe obesity and left ventricular dysfunction?
Bariatric surgery in patients with severe obesity and left ventricular dysfunction is associated with a higher rate of minor perioperative complications but yields significant improvements in LVEF and functional capacity at 1 year.
May improve LVEF despite minor complications in LV dysfunction; extends observational data but leaves randomized confirmation open.
INTRODUCTION: Obesity and heart failure with left ventricular ejection disfunction (LVED) are intertwined and rising worldwide. Weight loss through bariatric surgery improves cardiac function. We aimed to assess the incidence of perioperative complications in patients with severe obesity and LVED who had bariatric surgery, and the long-term effectiveness of surgery. METHODS: In a single-center observational retrospective study, we compared patients with body mass index ≥35 kg/m RESULTS: Overall, 79 patients were included, 38 with LVED (LVEF, 35 ± 9%) and 41 controls (LVEF, 59 ± 5%). There were not differences in baseline characteristics. The overall incidence of postoperative complications was similar. Patients with LVED had higher rate of minor complications (Clavien-Dindo grades 1 and 2, p < 0.05), which did not affect hospital length of stay (4 ± 5 vs. 3 ± 1 days) (p). After one year, bariatric surgery was effective with overall total weight loss of 34 ± 20%. Patients with LVED showed a 6 ± 10% increase in LVEF, and improvement in functional capacity. CONCLUSION: Patients with LVED have higher incidence of minor complications after bariatric surgery with no impact on length of hospitalization. Bariatric surgery is associated with a significant improvement in both LVEF and functional capacity.
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Diéguez-Porto et al. (2025) studied this question. Bariatric surgery improved left ventricular ejection fraction by 6% and functional capacity in patients with left ventricular dysfunction after a total weight loss of 34%.
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