Laparoscopic sleeve gastrectomy reduced BMI from 41.1 to 28.8 kg/m², decreased GAL-3 from 5.23 to 2.37 ng/mL, and improved LV global longitudinal strain from -16.0% to -18.6%.
Does laparoscopic sleeve gastrectomy improve cardiac functions, metabolic parameters, and quality of life in obese patients?
Laparoscopic sleeve gastrectomy in obese patients significantly improves subclinical myocardial function, metabolic parameters, and quality of life.
Absolute Event Rate: 0% vs 0%
Abstract Background Obesity-related cardiovascular diseases (CVD) have become a major cause of morbidity and mortality. There is a lack of comprehensive studies evaluating the effects of laparoscopic sleeve gastrectomy (LSG) on obesity-related CVD or subclinical myocardial damage. Purpose This study aims to investigate the effects of LSG on cardiac functions assessed by cardiac magnetic resonance (CMR), on patients’ CVD risk and quality of life (QoL), and on various biomarkers. Methods 32 consecutive obese patients who were scheduled for LSG were included. The patients were evaluated prior to LSG and following surgery. Left ventricular mass (LVM) and ejection fraction (LVEF), right ventricular EF (RVEF), stroke volume (LVSV), endsystolic volume (LVESV), end-diastolic volume (LVEDV), RVEDV, RVESV, RVCO, mitral annular plane systolic excursion (MAPSE) and left ventricular global longitudinal strain (LVGLS) analysis with cardiac MRI-FT technique were performed. The patients' 10-year CVD risk was estimated using the Framingham Risk Score (FRS). The QoL short form-36 (QoL SF-36) was administered. Blood specimens were analyzed for routine blood tests and by ELISA to measure the serum concentration of Endotrophin (ETP), Apelin, Adiponectin, Galectin-3 (GAL-3) and Fatty Acid Binding Protein 4 (FABP4). Results The mean age was 36.3 ± 7.6 years (81.3% women). Following LSG, BMI and waist circumference (WC) were reduced significantly (41.1 ± 4.8 kg/m² vs. 28.8 ± 4.1 kg/m², P 0.001; 120.0 ± 12.7 cm vs. 93.9 ± 11.6 cm, P 0.001, respectively); HDL and NT proBNP were elevated significantly; HbA1C, SBP, DBP, HR, WBC, CRP, GLU, ALT, AST, and TGA were significantly decreased; FRS reduced significantly (P 0.001). SF-36 QoL improved significantly in all parameters (P 0.001). Serum GAL-3 and ETP levels reduced significantly (5.23 ± 1.96 ng/mL vs. 2.37 ± 1.72 ng/mL, P 0.001; 0.009 ± 0.003 ng/mL vs. 0.006 ± 0.004 ng/mL, P 0.001, respectively) (Table 1). CMR-derived LVGLS, LVEF, MAPSE, RVEF improved (−16.0 ± 3.1% vs. −18.6 ± 3.8%, P = 0.003; 57.5 ± 4.3% vs. 59.3 ± 4.5%, P = 0.021; 11.7 ± 2.9 mm vs. 14.1 ± 4.4 mm, P = 0.004; 51.6 ± 6.4 vs. 54.4 ± 5.7, respectively). LV mass, LAV, Aortic root diameter, LVESV, LVCO, LVEDD, LVESD, and RVCO were significantly decreased (93.3 ± 17.8 g vs. 78.9 ± 13.0 g; 66.9 ± 14.7 ml vs. 58.3 ± 11.6 ml; 28.1 ± 3.0 mm vs. 27.4 ± 3.3 mm; 66.8 ± 16.8 ml vs. 60.4 ± 18.1 ml; 6.5 ± 1.2 ml/min vs. 5.3 ± 1.0 ml/min; 49.2 ± 5.5 mm vs. 46.5 ± 4.6 mm; 32.9 ± 6.0 mm vs. 30.5 ± 4.8 mm; 5.5 ± 1.2 ml/min vs. 4.7 ± 1.1 ml/min, respectively) (Table 2). Conclusions LSG improved BMI, and WC. Blood pressure, heart rate, HbA1c, glucose, lipid levels, GAL-3, ETP, and FRS decreased. All QoL parameters improved. CMR derived LV and RV systolic functions improved. LV and RV volume indices increased. Therefore, LSG may reverse obesity-induced cardiac derangements and improve inflammatory biomarkers, metabolic indices, individual’s CV risk, and QoL.Table 1 Table 2
Akarsu et al. (Sat,) reported a other. Laparoscopic sleeve gastrectomy reduced BMI from 41.1 to 28.8 kg/m², decreased GAL-3 from 5.23 to 2.37 ng/mL, and improved LV global longitudinal strain from -16.0% to -18.6%.