The effect of bariatric surgery type on cardiac reverse remodelling

• DOI: 10.1038/s41366-024-01474-x
• Publication Date: 2024-01-31T07:02:37Z
• Authors: J. A. Henry; I. Abdesselam; O. Deal; A. J. Lewis; J. Rayner; M. Bernard; A. Dutour; B. Gaborit; F. Kober; A. Soghomonian; B. Sgromo; J. Byrne; T. Bege; B. A. Borlaug; S. Neubauer; O. J. Rider
• Keywords: Sleeve gastrectomy; Adjustable gastric band; Roux-en-Y anastomosis; Gastric banding

Abstract Introduction Bariatric surgery is effective in reversing adverse cardiac remodelling obesity. However, it unclear whether the three commonly performed operations; Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Sleeve Gastrectomy (LSG) and Adjustable Band (LAGB) are equal their ability to reverse remodelling. Methods Fifty-eight patients underwent CMR assess left ventricular mass (LVM), LV mass:volume ratio (LVMVR) eccentricity index (LVei) before after bariatric (26 RYGB, 22 LSG 10 LAGB), including 46 with short-term (median 251–273 days) 43 longer-term 983–1027 follow-up. Abdominal visceral adipose tissue (VAT) epicardial (EAT) were also assessed. Results All procedures resulted significant decreases excess body weight (48–70%). Percentage change VAT EAT was significantly greater following RYGB compared LAGB at both timepoints (VAT:RYGB −47% −57%, −54%, −31% −25%; EAT:RYGB −13% −14%, –16% −19%, −5% −5%). Patients undergoing LAGB, whilst having reduced LVM (−1% −4%), had a smaller decrease short (RYGB: −8%, p < 0.005; LSG: −11%, 0.0001) long −12%, = 0.009; −13%, term timepoints. There LVMVR long-term timepoint (−7%, 0.006) 0.021), but not (−2%, 0.912). LVei appeared those (−3%, 0.063) (−4%, 0.015), (1%, 0.857). In all patients, correlated ( r 0.338, 0.0134), while 0.437, 0.001). Conclusions appear result adiposity, larger reductions LVM, concentric pericardial restraint than LAGB.