Effects of Sleeve Gastrectomy on Left Ventricular geometry and Cardiac Function

Background: Obesity is associated with adverse cardiovascular remodeling, including increased left ventricular (LV) mass and impaired diastolic function, which contribute to the development of heart failure with preserved ejection fraction. Bariatric surgery, particularly laparoscopic sleeve gastrectomy (LSG), induces substantial weight loss and metabolic improvement and may promote reverse cardiac remodeling; however, its effects on LV mass and diastolic function remain incompletely characterized.1-3 the aim of the study to evaluate the impact of laparoscopic sleeve gastrectomy on left ventricular mass and diastolic function in obese patients after achieving 20% total body weight loss. Methods: This prospective cohort study included 24 obese patients undergoing LSG. Comprehensive clinical, anthropometric, laboratory, and transthoracic echocardiographic assessments were performed preoperatively and after achieving 20% postoperative weight reduction. Echocardiographic evaluation focused on LV mass, LV mass index, systolic function, and diastolic parameters, including transmitral E/A ratio, tissue Doppler e′ velocities, E/e′ ratio, and tricuspid regurgitation velocity. Paired statistical analyses were applied to compare pre- and postoperative measurements. Results: Following LSG, patients demonstrated significant reductions in body weight and body mass index (both p < 0.001), accompanied by marked improvement in metabolic parameters. Left ventricular mass decreased significantly (p < 0.001), while LV mass index and ejection fraction showed no significant change. Diastolic function improved substantially, reflected by a significant increase in E/A ratio and lateral e′ velocity, along with a reduction in tricuspid regurgitation velocity. No significant correlation was observed between the magnitude of BMI reduction and changes in LV mass or diastolic indices. Conclusion: Laparoscopic sleeve gastrectomy is associated with significant regression of left ventricular mass and improvement in diastolic function in obese patients, with no significant correlation between the magnitude of BMI reduction and echocardiographic changes. These findings support a cardioprotective role for bariatric surgery and suggest potential benefits in preventing progression to heart failure related to obesity-induced cardiac remodeling.