The effects of bariatric surgery on cardiac function: a systematic review and meta-analysis

Int J Obes (Lond). 2024 Feb;48(2):166-176. doi: 10.1038/s41366-023-01412-3. Epub 2023 Nov 25.

Abstract

Introduction: Obesity is associated with alterations in cardiac structure and haemodynamics leading to cardiovascular mortality and morbidity. Culminating evidence suggests improvement of cardiac structure and function following bariatric surgery.

Objective: To evaluate the effect of bariatric surgery on cardiac structure and function in patients before and after bariatric surgery.

Methods: Systematic review and meta-analysis of studies reporting pre- and postoperative cardiac structure and function parameters on cardiac imaging in patients undergoing bariatric surgery.

Results: Eighty studies of 3332 patients were included. Bariatric surgery is associated with a statistically significant improvement in cardiac geometry and function including a decrease of 12.2% (95% CI 0.096-0.149; p < 0.001) in left ventricular (LV) mass index, an increase of 0.155 (95% CI 0.106-0.205; p < 0.001) in E/A ratio, a decrease of 2.012 mm (95% CI 1.356-2.699; p < 0.001) in left atrial diameter, a decrease of 1.16 mm (95% CI 0.62-1.69; p < 0.001) in LV diastolic dimension, and an increase of 1.636% (95% CI 0.706-2.566; p < 0.001) in LV ejection fraction after surgery.

Conclusion: Bariatric surgery led to reverse remodelling and improvement in cardiac geometry and function driven by metabolic and haemodynamic factors.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Bariatric Surgery* / methods
  • Heart
  • Humans
  • Obesity
  • Obesity, Morbid*
  • Ventricular Function, Left