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Erschienen in:
01.03.2014 | Original Contributions
Favorable Changes in Arterial Elasticity, Left Ventricular Mass, and Diastolic Function After Significant Weight Loss Following Laparoscopic Sleeve Gastrectomy in Obese Individuals
Erschienen in: Obesity Surgery | Ausgabe 3/2014
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Background
Obesity is accompanied by increased arterial stiffness, left ventricular (LV) hypertrophy, and diastolic dysfunction, all associated with a negative prognosis. The evolution of LV mass, function, and arterial elasticity after laparoscopic sleeve gastrectomy (LSG) was unknown, and this is what we have investigated.
Methods
Thirty-four consecutive obese subjects (mean age, 39 ± 11 years; 35.2 % men), scheduled for LSG, were studied before, at 6 and 12 months after surgery.
Results
The body mass index (BMI) decreased from 43.6 ± 11.9 to 32.1 ± 7.4 and to 28.9 ± 5.8 kg/m2 at 6 and 12 months after surgery (all p < 0.05). The baseline LV mass index was correlated with age, BMI, waist circumference, blood glucose level, systemic hypertension stage, and with aortic distensibility, strain, and stiffness index (all p < 0.05). Aortic distensibility increased by 110 %, aortic strain by 58 %, and aortic stiffness index decreased by 88 % at 6 months after LSG (all p
6 months–baseline < 0.05) and all the parameters had similar values at 12 months postoperatively (all p
12–6 months = NS). LV hypertrophy prevalence decreased from 61.8 to 47.1 % and to 32.3 % at 6 and 12 months after surgery (all p < 0.05). The proportion of patients with LV diastolic dysfunction decreased from 52.9 to 23.5 % at 6 months (p
6 months–baseline < 0.01) and to 20.6 % at 12 months postoperatively (p
12 –6 months = 0.7).
Conclusions
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.