Laparoscopic sleeve gastrectomy in metabolically healthy morbidly obese patients significantly decreased Left Ventricular Mass Index (from 51.11 to 44.57 g/m2) and improved the E/A ratio.
Cohort (n=53)
Does Laparoscopic Sleeve Gastrectomy improve left ventricular geometry and diastolic function in metabolically healthy morbidly obese patients?
Bariatric surgery induces favorable reverse cardiac remodeling and improves diastolic function at 6 months in metabolically healthy morbidly obese patients, independent of metabolic comorbidities.
Background: Obesity is an independent and major risk factor for cardiovascular diseases. However, the presence of common comorbidities such as diabetes and hypertension makes it difficult to understand the direct impact of obesity on the myocardium. The aim of this study is to evaluate the isolated effects of weight loss achieved after bariatric surgery on left ventricular (LV) geometry and diastolic functions in individuals with the “Metabolically Healthy Obese” (MHO) phenotype. Materials and Methods: The study included 28 patients (Surgical Group) who underwent Laparoscopic Sleeve Gastrectomy (LSG) between January 2022 and December 2025, had a preoperative Body Mass Index (BMI) > 40 kg/m2, and had no known cardiovascular or metabolic diseases. The control group consisted of 25 age- and gender-matched metabolically healthy morbidly obese patients who had not undergone surgery. Demographic and echocardiographic data of all participants were analyzed at baseline and at 6 months. Results: Weight Loss: In the surgical group, BMI decreased from 46.21 kg/m2 to 37.11 kg/m2 at the 6th month, while no significant change was observed in the control group. Cardiac Structure: In the surgical group, Left Ventricular Mass Index was significantly decreased from 51.11 g/m2 to 44.57 g/m2. Cardiac Function: The E/A ratio, an indicator of diastolic function, increased significantly from 1.19 to 1.34 in the surgical group, indicating notable improvement. No clinically meaningful change in systolic function was detected. Metabolic Parameters: The surgical group exhibited marked improvements in glucose and lipid profiles (decrease in Total Cholesterol, increase in HDL). Conclusions: The study demonstrates that bariatric surgery, independent of metabolic comorbidities, directly provides “reverse remodeling” of cardiac structure and improves function through reduction of adipose tissue and alleviation of hemodynamic load. These results support the effectiveness of surgery in reducing cardiovascular risk and preserving cardiac structure even in morbidly obese patients without comorbidities.
Duman et al. (Mon,) conducted a cohort in Metabolically Healthy Morbidly Obese (MHO) (n=53). Laparoscopic Sleeve Gastrectomy (LSG) vs. Age- and gender-matched metabolically healthy morbidly obese patients who had not undergone surgery was evaluated on Left ventricular (LV) geometry and diastolic functions (Left Ventricular Mass Index and E/A ratio). Laparoscopic sleeve gastrectomy in metabolically healthy morbidly obese patients significantly decreased Left Ventricular Mass Index (from 51.11 to 44.57 g/m2) and improved the E/A ratio.
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