Effect of laparoscopic sleeve gastrectomy on heart remodeling and right ventricular function.

Background: Weight loss following bariatric surgery reduces cardiovascular workload and may improve cardiac structure and function. This study aimed to assess changes in right heart echocardiographic parameters and cardiac remodeling six months after laparoscopic sleeve gastrectomy (LSG). Methods: In this cross-sectional study, patients who underwent LSG between 2022 and 2024 were evaluated before surgery and at six-month follow-up. Demographic data, clinical variables, and comprehensive echocardiographic indices of cardiac function were recorded and compared. Results: Twenty-two patients (mean age 38.09±9.47 years) were included. Significant postoperative improvements were observed in left ventricular ejection fraction (55.84±6.49% to 62.86 ± 4.41%, p<0.001), right ventricular peak systolic myocardial velocity (12.22±2.59 to 14.24±2.38 cm/s, p<0.001), tricuspid annular plane systolic excursion (22.95±3.03 to 24.18±2.82 mm, p=0.04), E wave velocity (7.35±2.01 to 9.54±1.98 cm/s, p<0.001), and left ventricular global longitudinal strain (15.42±3.86 to 18.24±2.93, p<0.001). Significant reductions were noted in right ventricular diameter, left ventricular end-diastolic and end-systolic volumes, and pulmonary artery pressure (all p<0.01). The prevalence of diastolic dysfunction decreased markedly from 63.6% preoperatively to 13.6% postoperatively (p<0.001). Conclusion: Laparoscopic sleeve gastrectomy is associated with significant improvement in cardiac remodeling and both left and right ventricular function, with notable enhancement of right heart echocardiographic parameters.