Key result
Surgical weight loss links to a ~4 unit improvement in LV GLS versus non-surgical methods.
Why the study?
The impact of non-surgical versus surgical weight loss on myocardial function in overweight Asian subjects had not been evaluated.
Does surgical weight loss improve echocardiographic and strain parameters compared to non-surgical weight loss in overweight and obese Asian patients?
Cohort (n=88)
No
Does surgical weight loss improve echocardiographic and strain parameters compared to non-surgical weight loss in overweight and obese Asian patients?
Effect estimate: Coefficient -4.01 (95% CI -6.46 to -1.56)
p-value: p=0.001
Surgical weight loss, but not non-surgical weight loss, significantly improves subclinical myocardial dysfunction in Asian patients with obesity, independent of the degree of BMI reduction.
Surgical weight loss was associated with greater LV strain improvement than non-surgical approaches in obese Asians; leaves open need for RCTs to confirm causality and outcomes.
Surgical weight loss (SWL) improves myocardial mechanics as measured by speckle-tracking imaging. However non-surgical versus SWL and the subsequent impact on myocardial function in overweight Asian subjects has not been evaluated. 66 patients underwent a 16-week lifestyle intervention (LSI) programme consisting of dietary interventions and exercise prescription. Echocardiography with speckle tracking was performed at baseline and post-intervention. This group was compared against a group of 12 subjects who had undergone bariatric surgery and a control group of 10 lean Asian subjects. A generalised structural equation model (gSEM) was constructed to ascertain the effect of modality of weight loss on strain parameters, adjusting for BMI. Participants attained significant weight loss after LSI (28.2 ± 2.66 kg/m2 vs. 25.8 ± 2.84 kg/m2, p = 0.001). This was associated with a non-significant trend towards improvement in strain parameters. SWL participants had significant improvement in the left ventricular global longitudinal strain (− 20.52 ± 3.34 vs. − 16.68 ± 4.15, p < 0.01) and left atrium reservoir strain (44.32 ± 14.23 vs. 34.3 ± 19.31, p = 0.02). Lean subjects had significantly higher strain parameters than overweight subjects. The gSEM model demonstrated surgical modality of weight loss as an independent predictor of improvement in strain parameters. Significant improvement in echocardiographic parameters were documented in patients who underwent bariatric surgery.
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Poh et al. (2024) conducted a cohort in Obesity and overweight (n=88). Surgical weight loss (bariatric surgery) vs. Non-surgical weight loss (lifestyle intervention) was evaluated on Left Ventricle Strain (gSEM adjusted for BMI) (Coefficient -4.01, 95% CI -6.46 to -1.56, p=0.001). Surgical weight loss independently improved left ventricular global longitudinal strain by 4.01 units compared to non-surgical weight loss in Asian patients with obesity.
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