The effect of weight loss on the cardiac structure and function after laparoscopic adjustable gastric banding surgery in morbidly obese individuals

Abstract

Background: Herein, we investigate the anthropometric, biochemical and left ventricle (LV) geometry changes following the laparoscopic adjustable gastric banding (LAGB) operation in morbidly obese individuals.

Methods: Eighty-three morbidly obese participants (mean age, 46.1 ± 11.5 years; 30.1 % men), scheduled for elective LAGB were examined before and 12 months after the surgery. LV geometry and diastolic function were investigated by 2-dimensional echocardiography, whereas laboratory tests assessed the glycaemic, serum lipid and inflammatory marker profiles.

Results: Twelve months after the operation, body mass index (BMI) decreased from 46.9 ± 7.2 kg/m(2) to 40.1 ± 8.2 kg/m(2) (p < 0.05), which was associated with the significant improvements in glycaemic control, inflammatory state, LV end-diastolic diameter (53.6 ± 4.6 mm vs. 52.9 ± 4.1 mm, p < 0.05), LV mass (223.6 ± 61.3 vs. 215.4 ± 52.7 g, p < 0.05) and LV mass index (53.9 ± 14.1 g/m(2.7) vs. 52.0 ± 12.3 g/m(2.7), p < 0.05). However, no overall improvements in LV geometry or the prevalence of LV hypertrophy subtypes were recorded 12 months after the LAGB. The reduction in LV end-diastolic diameter (ß = 0.56, p = 0.0001) and BMI (ß = 0.26, p = 0.015) were both associated with diminished LV mass. Additionally, a statistically significant correlation between LV mass and changes in BMI (R = 0.29, p = 0.007), waist circumference (R = 0.32, p = 0.004), LV end-diastolic diameter (R = 0.63, p = 0.0001) and E-wave deceleration time (R = -0.24, p = 0.03) were observed within our study population.

Conclusions: LV mass decreases 12 months after LAGB surgery, but no improvements in LV geometry and function occur. The regression of LV mass is better predicted by weight loss than by reduction in blood pressure or changes in metabolic parameters.