The Effect of Bariatric Surgery on Left Atrium Mechanical Activity, Left Atrial Strain, and Diastolic Function

Background: As a widespread global health concern, obesity frequently results in cardiovascular complications. Bariatric surgery has emerged as an effective intervention for managing severe obesity in cases where conventional weight-loss methods have proven unsuccessful. This investigation aimed to evaluate alterations in left atrial (LA) mechanical activity, atrial strain parameters, and diastolic function following bariatric surgery. Materials and Methods: In this quasi-experimental longitudinal study, patients scheduled for bariatric procedures at Imam Hossein Hospital (Tehran, Iran) between March 2021 and March 2022 were enrolled. Comprehensive echocardiographic assessments were performed pre- and post-operatively, followed by detailed statistical evaluation. Results: The study cohort comprised 22 individuals with a mean age of 40.27 ± 9.79 years, predominantly female (72.2%). A substantial reduction in mean body mass index was documented, decreasing from 43.68 ± 5.17 kg/m² to 36.09 ± 4.94 kg/m² (p < 0.001). Among comorbidities, diabetes mellitus was most prevalent (31.8%). Postoperative assessments revealed significant reductions in multiple cardiac parameters (p < 0.05), including left ventricular end-diastolic and end-systolic dimensions, right ventricular diastolic diameter, LA dimensions, atrial volume, and pericardial adipose tissue. Concurrently, significant improvements were observed in septal and lateral É values, alongside enhanced LA reservoir and conduit functions (p < 0.05). Conclusion: The results demonstrate that bariatric surgery produces favorable modifications in diastolic performance and left atrial dynamics. Additionally, the procedure positively influences functional parameters of both ventricular chambers.