June 22, 2026Journal of the American College of Cardiology
Reversibility of Cardiac Abnormalities in Morbidly Obese Adolescents
Key result
Adolescent bariatric surgery is linked to a ~22% reduction in LV mass index and improved diastolic function.
- P<0.0001
- n=38
Why the study?
Cardiac abnormalities occur in morbidly obese adolescents, but whether they are reversible with weight loss remains unclear.
Does bariatric surgery improve cardiac geometry, systolic and diastolic function in morbidly obese adolescents?
Key Points
- This study aims to evaluate the changes in cardiac geometry and function in morbidly obese adolescents following weight loss through bariatric surgery.
- Evaluated 38 adolescents (ages 13-19) before and after bariatric surgery.
- Assessed left ventricular mass, geometry, and function using echocardiography with a follow-up of 10 +/- 3 months.
- Analyzed changes in weight and body mass index pre- and post-surgery.
- Mean weight loss of 59 +/- 15 kg observed post-operatively, with significant reduction in body mass index from 60 +/- 9 kg/m(2) to 40 +/- 8 kg/m(2) (p < 0.0001).
- Prevalence of concentric left ventricular hypertrophy improved from 28% pre-operative to 3% at follow-up (p = 0.007).
- Diastolic function improved significantly, with mitral E/Ea changing from 7.7 +/- 2.3 pre-operative to 6.3 +/- 1.6 post-operative (p = 0.003).
Study Design
Type
Observational (n=38)
Structured PICO
Does bariatric surgery improve cardiac geometry, systolic and diastolic function in morbidly obese adolescents?
P
Population
38 morbidly obese adolescents (13 to 19 years, 76% female) evaluated before and after bariatric surgery with a mean follow-up of 10 months.
E
Exposure
Bariatric surgery
C
Comparator
Pre-operative baseline
O
Outcome
Changes in cardiac geometry, systolic and diastolic function assessed by echocardiography at mean 10 +/- 3 months follow upsurrogate
Main Result
Absolute Event Rate: 42% vs 54%
p-value: p=< 0.0001
Surgically induced weight loss in morbidly obese adolescents significantly improves surrogate markers of cardiovascular morbidity, including LVM index, LV geometry, and diastolic function.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“There is generally a plateau [of weight loss] at about 6-12 months, and sometimes a creep-up after 1 year. Even though [these adolescents] are significantly better, they're still not normal, so we should intervene even sooner.”
“Diminishing weight loss more than 6 months out from surgery is very interesting and is being seen at a number of U.S. centers that are doing bariatric surgery on adolescents. It's something that we don't understand and need to learn more about.”
Implication
May support cardiac benefits from bariatric surgery in obese adolescents; hypothesis-generating, needs randomized confirmation before practice change.
Abstract
OBJECTIVES: The purpose of this study was to evaluate changes in cardiac geometry, systolic and diastolic function before and after weight loss in morbidly obese adolescents. BACKGROUND: Cardiac abnormalities are present in morbidly obese adolescents; however, it is unclear if they are reversible with weight loss. METHODS: Data from 38 adolescents (13 to 19 years; 29 females, 9 males, 33 Caucasians, 5 African Americans) were evaluated before and after bariatric surgery. Left ventricular mass (LVM), left ventricular (LV) geometry, systolic and diastolic function were assessed by echocardiography. Mean follow up was 10 +/- 3 months. RESULTS: Weight and body mass index decreased post-operatively (mean weight loss 59 +/- 15 kg, pre-operative body mass index 60 +/- 9 kg/m(2) vs. follow-up 40 +/- 8 kg/m(2), p < 0.0001). Change in LVM index (54 +/- 13 g/m(2.7) to 42 +/- 10 g/m(2.7), p < 0.0001) correlated with weight loss (r = 0.41, p = 0.01). Prevalence of concentric left ventricular hypertrophy (LVH) improved from 28% at pre-operative to only 3% at follow up (p = 0.007), and normal LV geometry improved from 36% to 79% at follow up (p = 0.009). Diastolic function also improved (mitral E/Ea lateral 7.7 +/- 2.3 at pre-operative vs. 6.3 +/- 1.6 at post-operative, p = 0.003). In addition, rate-pressure product improved suggesting decreased cardiac workload (p < 0.001). CONCLUSIONS: Elevated LVM index, concentric LVH, altered diastolic function, and cardiac workload significantly improve following surgically induced weight loss in morbidly obese adolescents. Large weight loss due to bariatric surgery improves predictors of future cardiovascular morbidity in these young people.
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Cite This Study
Ippisch et al. (2008) conducted an observational in Morbid obesity (n=38). Bariatric surgery vs. Pre-operative baseline was evaluated on Left ventricular mass (LVM) index (p=< 0.0001). Bariatric surgery in morbidly obese adolescents significantly reduced left ventricular mass index from 54 to 42 g/m2.7 (p<0.0001) and improved left ventricular geometry and diastolic function.