Short-term rapid weight loss induced by bariatric surgery improves ventricular ejection fraction in patients with severe obesity and heart failure

Abstract

Background: Obesity is a major risk factor for the development of metabolic syndrome, coronary artery disease, and heart failure (HF). Rapid weight loss following bariatric surgery can significantly improve outcomes for patients with these diseases.

Objectives: To assess whether bariatric surgery improves ventricular ejection fraction in patients with obesity who have heart failure.

Setting: Private practice, United States.

Methods: We conducted a retrospective review of echocardiographic changes in systolic functions in patients with obesity that underwent bariatric surgery at our institution. Patients were divided into 2 groups, those (1) without known preoperative HF and (2) with preoperative HF. We compared the left ventricular ejection fraction (LVEF) before and after bariatric surgery in both groups. Common demographics and co-morbidities were also analyzed.

Results: A total of 68 patients were included in the analysis: 49 patients in group 1 and 19 in group 2. In group 1, 59.2% (n = 29) of patients were female, versus 57.9% (n = 11) in group 2. The excess body mass index lost at 12 months was 52.06 ± 23.18% for group 1 versus 67.12 ± 19.27% for group 2 (P = .0001). Patients with heart failure showed a significant improvement in LVEF, from 38.79 ± 13.26% before to 48.47 ± 14.57% after bariatric surgery (P = .039). Systolic function in patients from group 1 showed no significant changes (59.90 ± 6.37 mmHg) before and (59.88 ± 7.85 mmHg) after surgery (P = .98).

Conclusion: Rapid weight loss after bariatric surgery is associated with a considerable increase in LVEF and a significant improvement of systolic function.

Keywords: Bariatric surgery; Heart failure; Obesity; Ventricular ejection fraction.