Key result
Bariatric surgery improves left ventricular global longitudinal strain by ~3% in patients with obesity.
Why the study?
Current evidence on the effects of bariatric surgery on cardiac mechanics in patients with obesity was limited to a few single studies.
Does bariatric surgery improve left ventricular global longitudinal strain in patients with obesity?
Meta-Analysis (n=512)
Yes
Does bariatric surgery improve left ventricular global longitudinal strain in patients with obesity?
Standardized Mean Difference: 0.5 (95% CI 0.34–0.65)
Absolute Event Rate: -19.9% vs -16.9%
p-value: p=<0.0001
Bariatric surgery results in significant improvements in left ventricular systolic mechanics measured by global longitudinal strain, highlighting the role of advanced echocardiography for monitoring cardiac reverse remodeling.
Supports GLS monitoring of reverse remodeling after bariatric surgery; extends meta-analytic evidence for myocardial recovery in obesity.
Aim: Current evidence on the effects of bariatric surgery on cardiac mechanics in patients with obesity is based on a few single studies. We investigated this issue through a meta-analysis of speckle tracking echocardiography (STE) studies that reported data on changes in left ventricular (LV) mechanics as assessed by global longitudinal strain (GLS). Methods: The PubMed, OVID-MEDLINE and Cochrane library databases were systematically analysed to search English-language articles published from inception to 31 May 2022. Studies were identified by using Me-SH terms and crossing the following terms: “obesity”, “bariatric surgery”, “left ventricular mechanics”, “left ventricular hypertrophy”, “systolic dysfunction”, “global longitudinal strain”, “echocardiography” and “STE echocardiography”. Results: The meta-analysis, including a total of 512 patients with obesity from 13 studies (follow-up 1−23 months), showed a significant GLS improvement after bariatric procedures, with standard mean difference (SMD) being 0.50 ± 0.08, CI: 0.34/0.65, p < 0.0001. Corresponding SMD value for LV ejection fraction (LVEF) was 0.15 ± 0.09, CI: −0.04/0.34, p = 0.11. A sensitivity analysis restricted to 11 studies with follow-up ≥ 6 months confirmed that GLS (SMD: 0.47 ± 0.08, CI: 0.30/0.63, p < 0.0001) but not LVEF (SMD: 0.14 ± 0.11, CI: −0.08/0.37, p = 0.21) improved after surgery. Conclusions: Our meta-analysis adds a new piece of information on the beneficial effects of bariatric surgery on LV systolic function and, more importantly, suggests that the assessment of myocardial strain should be routinely implemented for a comprehensive evaluation of cardiac functional changes associated with bariatric procedures.
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Gherbesi et al. (2022) conducted a meta-analysis in Obesity (n=512). Bariatric surgery vs. Baseline (pre-surgery) was evaluated on Changes in left ventricular global longitudinal strain (GLS) (SMD 0.50, 95% CI 0.34-0.65, p=<0.0001). Bariatric surgery significantly improved left ventricular global longitudinal strain (SMD 0.50) compared to pre-surgery baseline in patients with obesity.
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