Cardiac Remodeling in Obese Patients After Laparoscopic Sleeve Gastrectomy

Background Obesity is associated with high morbidity and represents an increasing health care problem worldwide. Laparoscopic sleeve gastrectomy (LSG) has been used effectively for weight loss and co-morbidity remission. In this retrospective study, we evaluated cardiac reverse remodeling at medium-term follow-up by echocardiography, the amount of cardiovascular medications, and the impact of co-morbidities after sleeve gastrectomy. Methods Altogether, 16 obese patients (4 men, 12 women; 46.4 +/- 10.3 years) underwent complete clinical evaluation, laboratory tests, and color Doppler/tissue Doppler imaging echocardiography preoperatively and 12-20 months after bariatric surgery. Results Body weight (mean body mass index) was significantly reduced (from 44.8 +/- 8.0 to 31.2 +/- 7.8 kg/m(2); p = 0.001). Lipid profile significantly improved: total cholesterol and triglycerides decreased (respectively: 215.5 +/- 53.8 vs. 205.3 +/- 46.6 mg/dl and 184.9 +/- 109.3 vs. 116.1 +/- 49.9 mg/dl, both p <= 0.05), and high-density lipoprotein increased (43.1 +/- 10.9 vs. 51.4 +/- 12.8 mg/dl, p = 0.005). Systolic blood pressure significantly decreased (from 133.0 +/- 17.1 to 120.6 +/- 13.7 mmHg; p = 0.04). Diabetes remission was complete in five of six patients (83 %) and sleep apnea in four of five (80 %). Echocardiography showed significantly reduced interventricular septum and posterior wall thickness (11.3 +/- 1.8 to 9.4 +/- 2.1 mm and 10.4 +/- 1.7 to 8.6 +/- 1.9 mm, respectively; both p < 0.007) and reduced left ventricular mass (absolute value and indexed by height, respectively: 222.41 +/- 78.2 to 172.75 +/- 66.3 g (p = 0.003) and 55.9 +/- 14.3 to 43.8 +/- 17.2 g/m(2.7) (p = 0.0004). Antihypertensive drug intake was significantly reduced (p = 0.03), as shown by the 10-year Framingham Risk Score (from 14.2 +/- 9.3 to 8.3 +/- 9.5 %, p = 0.003). Conclusions Sleeve gastrectomy is associated with marked improvement in terms of weight loss, lipid profile, type 2 diabetes, sleep apnea, hypertension, and left ventricular hypertrophy, with a significantly reduced Framingham Risk Score.