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The Early Effects of Bariatric Surgery on Cardiac Structure and Function: a Systematic Review and Meta-Analysis

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Abstract

Background

This meta-analysis was performed to investigate how cardiac structures and functions change in the very early stage after bariatric surgery.

Materials and Methods

We thoroughly searched the PubMed, Embase, Cochrane Library, and Web of Science databases for articles including patients who underwent bariatric surgery and examined the changes of their cardiac indices. Results were pooled by using Review Manager 5.1 and Stata 12.0. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) were obtained. The I-squared (I2) test was used to determine the heterogeneity between studies. To identify publication bias, funnel plots and Egger’s test were utilized. The leave-one-out method was used to conduct sensitivity analysis.

Results

In this meta-analysis, 24 research including 942 patients were considered. According to our findings, most cardiac indices changed 3–6 months following bariatric surgery. An improvement in cardiac geometry was reflected by a reduction in left ventricular mass (LVM) (WMD =  − 22.06, 95% CI = (− 27.97, − 16.16)). The left ventricular diastolic function improved, as reflected by the decrease in the E/e’ ratio (WMD =  − 0.90, 95% CI = (− 1.83, − 0.16)). Left ventricular ejection fraction (LVEF) did not show an obvious change (WMD = 0.94, 95% CI = (− 0.19, 2.07)), while a more sensitive indicator of left ventricular systolic function, left ventricular longitudinal strain (LV LS), increased (WMD =  − 2.43, 95% CI = (− 3.96, − 0.89)).

Conclusion

This meta-analysis includes the newest and most comprehensive cardiac indices to prove that cardiac structures and functions are improved early after bariatric surgery, which has not been reported by any other studies.

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Funding

This work was supported by the National Natural Science Foundation of China [81820108007, 81800745].

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Authors and Affiliations

  1. National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China

    Shanya Huang, Yi Lan, Chunlan Zhang, Jingjing Zhang & Zhiguang Zhou

  2. Department of Ultrasound Diagnosis, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China

    Shanya Huang & Yi Lan

Authors
  1. Shanya Huang
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  2. Yi Lan
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  3. Chunlan Zhang
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  4. Jingjing Zhang
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Contributions

Conceptualization: S.H.. Methodology: S.H., Y.L., and J.Z.. Software: S.H.. Validation: S.H., Y.L., J.Z., and Z.Z.. Formal analysis: S.H.. Investigation: S.H.. Resources: S.H. and Y.L. Data curation: S.H.. Writing—original draft preparation: S.H.. Writing—review and editing: C.Z. Visualization: S.H.. Supervision: J.Z. and Z.Z.. Project administration: J.Z. and Z.Z.. Funding acquisition: Z.Z. All authors have read and agreed to the published version of the manuscript.

Corresponding authors

Correspondence to Jingjing Zhang or Zhiguang Zhou.

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Key points

1. This is the first meta-analysis specifically focusing on the change in cardiac function and structure early (within 6 months) after bariatric surgery and including the most comprehensive cardiac indices.

2. We validated that cardiac structures and functions have improved early after bariatric surgery.

3. We found that LV LS, a new cardiac index using ultrasound speckle tracking technology, can detect subtle changes in cardiac systolic function before LVEF change, and after bariatric surgery, the LV LS improved.

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Huang, S., Lan, Y., Zhang, C. et al. The Early Effects of Bariatric Surgery on Cardiac Structure and Function: a Systematic Review and Meta-Analysis. OBES SURG 33, 453–468 (2023). https://doi.org/10.1007/s11695-022-06366-5

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