The Influence of Surgical Weight Reduction on Left Atrial Strain

Strzelczyk, Jakub; Kalinowski, Piotr; Zieniewicz, Krzysztof; Szmigielski, Cezary; Byra, Michał; Styczyński, Grzegorz

doi:10.1007/s11695-021-05710-5

Cited by 9 publications

(4 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…28 Moreover, Strzelczyk et al demonstrated an increase in LARS after bariatric surgery in patients with severe obesity without previous history of cardiac disease or arrhythmia. 29 The moderate correlation between ΔLARS and MAP (and ΔMAP) observed in our study supports previous cross-sectional data demonstrating a link between elevated BP and impaired LARS. 25,30,31 Our results emphasize the importance of managing both BP and weight to hamper the progression of cardiac maladaptation.…”

Section: δLars (%) δLaef (%)supporting

confidence: 91%

Clinical and biochemical predictors of longitudinal changes in left atrial structure and function: A general population study

Kuznetsova,

Daels,

Ntalianis

et al. 2024

Echocardiography

View full text Add to dashboard Cite

PurposeThere is a need for better understanding the factors that modulate left atrial (LA) dysfunction. Therefore, we determined associations of clinical and biochemical biomarkers with serial changes in echocardiographic indexes of LA function in the general population.MethodsWe measured LA maximal and minimal volume indexes (LAVImax and LAVImin) by echocardiography and LA reservoir strain (LARS) by two‐dimensional speckle‐tracking in 627 participants (mean age 50.8 years, 51.2% women) at baseline and after 4.8 years.ResultsDuring follow‐up, LARS decreased significantly in men (−.90%, P = .033) but not in women (−.23%, P = .60). In stepwise regression analysis, stronger decrease in LARS over time was associated with male sex, a higher age, body mass index (BMI), mean arterial pressure (MAP) and serum insulin at baseline and with a greater increase in BMI and MAP over time (P ≤ .018). Similarly, an increased risk of developing or retaining abnormal LARS was observed in older participants, in subjects with a higher baseline BMI, MAP, heart rate (HR), troponin T and ΔMAP, and in those who used β‐blockers at baseline. Both LAVImax and LAVImin increased significantly over time (P ≤ .0007). This increase was associated with a higher baseline age, pulse pressure and a lower HR at baseline and a greater increase in pulse pressure over time (P ≤ .029). Higher serum insulin and D‐dimer were independently associated with a stronger increase in LAVImin (P ≤ .0034).ConclusionSubclinical worsening in LA dysfunction was associated with older age, hypertension, obesity, insulin resistance and troponin T levels. Cardiovascular risk management strategies may delay LA deterioration.

show abstract

Section: δLars (%) δLaef (%)supporting

confidence: 91%

Clinical and biochemical predictors of longitudinal changes in left atrial structure and function: A general population study

Kuznetsova,

Daels,

Ntalianis

et al. 2024

Echocardiography

View full text Add to dashboard Cite

show abstract

“…Strzelcyk et al observed similar results and reported a significant increase in LASr and LAScd after bariatric surgery, and a decrease in LASct [ 39 ]. The authors explained the decrease in LASct in their study mechanistically as an improvement of early LV diastolic filling that may lead to a relative decrease of the contribution of atrial contraction [ 39 ]. Bariatric surgery leads to complex metabolic and hemodynamic changes.…”

Section: Discussionmentioning

confidence: 69%

Decreased left atrial function in obesity patients without known cardiovascular disease

Aga

Kroon

Snelder

et al. 2022

Int J Cardiovasc Imaging

View full text Add to dashboard Cite

Obesity is a risk factor for heart failure with preserved ejection fraction (HFpEF). We hypothesized that assessment of left atrial (LA) strain may be useful to reveal precursors of HFpEF in obesity patients. Echocardiograms of obesity patients without known cardiovascular disease who underwent bariatric surgery, and echocardiograms of age- and gender matched controls were analyzed. The echocardiogram was repeated 1 year after bariatric surgery. LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contractile strain (LASct) were measured. 77 Obesity patients were compared with 46 non-obese controls. Obesity patients showed a significantly decreased LA function compared with non-obese individuals (LASr 32.2% ± 8.8% vs. 39.6% ± 10.8%, p < 0.001; LAScd 20.1% ± 7.5% vs. 24.9% ± 8.3%, p = 0.001; LASct 12.1% ± 3.6% vs. 14.5% ± 5.5%, p = 0.005). There was no difference in prevalence of diastolic dysfunction between the obesity group and controls (9.1% vs. 2.2%, p = 0.139). One year after bariatric surgery, LASr improved (32.1% ± 8.9% vs. 34.2% ± 8.7%, p = 0.048). In the multivariable linear regression analysis, BMI was associated with LASr, LAScd, and LASct (β = − 0.34, CI − 0.54 to − 0.13; β = − 0.22, CI − 0.38 to − 0.06; β = − 0.10, CI − 0.20 to − 0.004). Obesity patients without known cardiovascular disease have impairment in all phases of LA function. LA dysfunction in obesity may be an early sign of cardiac disease and may be a predictor for developing HFpEF. LASr improved 1 year after bariatric surgery, indicating potential reversibility of LA function in obesity.

show abstract

“…In this study, LA cavity size followed a similar trajectory to LV cavity size, initially falling in size and then increasing from 212 days onwards. Previous studies have also shown a decrease in LA volume within 1 year of bariatric surgery ( 43 , 44 ), with other studies reporting no change in LA volume after 1 year ( 41 , 45 , 46 ), and increased LA volume after 5 years ( 34 ). Whilst the initial reduction in size follows the reduction in cardiac output, as for the LV, the loss of EAT from the pericardial space may again allow further space for this LA cavity dilation to occur.…”

Section: Discussionmentioning

confidence: 76%

Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry

Henry¹,

Abdesselam²,

Deal³

et al. 2023

Front. Endocrinol.

View full text Add to dashboard Cite

IntroductionObesity affects cardiac geometry, causing both eccentric (due to increased cardiac output) and concentric (due to insulin resistance) remodelling. Following bariatric surgery, reversal of both processes should occur. Furthermore, epicardial adipose tissue loss following bariatric surgery may reduce pericardial restraint, allowing further chamber expansion. We investigated these changes in a serial imaging study of adipose depots and cardiac geometry following bariatric surgery.Methods62 patients underwent cardiac magnetic resonance (CMR) before and after bariatric surgery, including 36 with short-term (median 212 days), 37 medium-term (median 428 days) and 32 long-term (median 1030 days) follow-up. CMR was used to assess cardiac geometry (left atrial volume (LAV) and left ventricular end-diastolic volume (LVEDV)), LV mass (LVM) and LV eccentricity index (LVei – a marker of pericardial restraint). Abdominal visceral (VAT) and epicardial (EAT) adipose tissue were also measured.ResultsPatients on average had lost 21kg (38.9% excess weight loss, EWL) at 212 days and 36kg (64.7% EWL) at 1030 days following bariatric surgery. Most VAT and EAT loss (43% and 14%, p<0.0001) occurred within the first 212 days, with non-significant reductions thereafter. In the short-term LVM (7.4%), LVEDV (8.6%) and LAV (13%) all decreased (all p<0.0001), with change in cardiac output correlated with LVEDV (r=0.35,p=0.03) and LAV change (r=0.37,p=0.03). Whereas LVM continued to decrease with time (12% decrease relative to baseline at 1030 days, p<0.0001), both LAV and LVEDV had returned to baseline by 1030 days. LV mass:volume ratio (a marker of concentric hypertrophy) reached its nadir at the longest timepoint (p<0.001). At baseline, LVei correlated with baseline EAT (r=0.37,p=0.0040), and decreased significantly from 1.09 at baseline to a low of 1.04 at 428 days (p<0.0001). Furthermore, change in EAT following bariatric surgery correlated with change in LVei (r=0.43,p=0.0007).ConclusionsCardiac volumes show a biphasic response to weight loss, initially becoming smaller and then returning to pre-operative sizes by 1030 days. We propose this is due to an initial reversal of eccentric remodelling followed by reversal of concentric remodelling. Furthermore, we provide evidence for a role of EAT contributing to pericardial restraint, with EAT loss improving markers of pericardial restraint.

show abstract

The Influence of Surgical Weight Reduction on Left Atrial Strain

Cited by 9 publications

References 50 publications

Clinical and biochemical predictors of longitudinal changes in left atrial structure and function: A general population study

Clinical and biochemical predictors of longitudinal changes in left atrial structure and function: A general population study

Decreased left atrial function in obesity patients without known cardiovascular disease

Changes in epicardial and visceral adipose tissue depots following bariatric surgery and their effect on cardiac geometry

Contact Info

Product

Resources

About