Favorable Changes in Arterial Elasticity, Left Ventricular Mass, and Diastolic Function After Significant Weight Loss Following Laparoscopic Sleeve Gastrectomy in Obese Individuals

Abstract

Significant improvements of aortic elasticity and of LV diastolic function were recorded at 6 months, and they were maintained at 12 months after LSG. The LV hypertrophy showed also a favorable evolution: it has been slightly improved 6 months after surgery and further ameliorated 1 year postoperatively.

Influence of obesity in central blood pressure

“…In contrast, nonsignificant and negative associations between BMI and PWV have been reported in cross-sectional studies [18,28,29] when peripheral BP was adjusted for. They showed early and long-lasting improvement of arterial stiffness parameters [36][37][38][39], indicating a fast and direct relationship between changes of body weight and arterial wall properties. Small heterogeneous studies reported increased arterial stiffness in young obese patients [30][31][32].…”

Cardiac structure and function before and after bariatric surgery: a clinical overview

“…In almost every study, LVM, LVM/height 2.7 or LVM/BSA decreases significantly after 336 months and even after 3.6–10 years of excessive weight loss . It continues to decrease linearly up to 24–36 months, while most other variables, such as weight loss, plateau after several months .…”

“…The effect of excessive weight loss on blood pressure varies widely. Several studies indicate both a short and long term significant improvement in systolic and diastolic blood pressure , as well as a significant decrease in mean arterial blood pressure . However other studies show only a long term significant decrease in systolic blood pressure , while others have the opposite results; a significant decrease only in diastolic blood pressure .…”

“…Diastolic dysfunction is quite common in patients with obesity , which is probably a consequence of obesity, given the higher incidence of LVH. The ratio of the mitral peak velocity of early filling to late filling (E/A‐ratio) is <1 in 17–52.9% of the patients with obesity , are significantly lower compared to the lean . Also, increased deceleration time and isovolumetric relaxation time are found in patients with obesity , as well as increased LA dimensions .…”

“…Most people with obesity develop significant weight loss after bariatric surgery; however, many remain clinically obese with a BMI around 29–34 kg/m 2 after 3–36 months and even after 10 years of surgery . Most weight loss is seen in the first 3 months and declines in the months thereafter, with a smaller decrease in weight 6–36 months after surgery , .Cardiac remodelling is most likely to occur in these first 3 months, and probably reaches a plateau by approximately 2 years. This assumption is based on the weight loss profiles in the Swedish obese subjects (SOS) study from Sjöström et al .…”