Preoperative risk factors associated with left ventricular dysfunction after bariatric surgery

Sci Rep. 2024 Jan 25;14(1):2173. doi: 10.1038/s41598-024-52623-1.

Abstract

A large proportion of patients with severe obesity remain with left ventricular (LV) dysfunction after bariatric surgery. We assessed whether preoperative evaluation by echocardiography and inflammatory proteins can identify this high-risk group. In the Bariatric Surgery on the West Coast of Norway study, 75 patients (44 ± 10 years, body mass index [BMI] 41.5 ± 4.7 kg/m2) were prospectively evaluated by echocardiography and inflammatory proteins (high-sensitivity C-reactive protein [hsCRP], serum amyloid A [SAA] and calprotectin) before and one year after Roux-en-Y gastric bypass surgery. LV mechanics was assessed by the midwall shortening (MWS) and global longitudinal strain (GLS). Bariatric surgery improved BMI and GLS, and lowered hsCRP, calprotectin and SAA (p < 0.05). MWS remained unchanged and 35% of patients had impaired MWS at 1-year follow-up. A preoperative risk index including sex, hypertension, ejection fraction (EF) and high hsCRP (index 1) or SAA (index 2) predicted low 1-year MWS with 81% sensitivity/71% specificity (index 1), and 77% sensitivity/77% specificity (index 2) in ROC analyses (AUC 0.80 and 0.79, p < 0.001). Among individuals with severe obesity, women and patients with hypertension, increased serum levels of inflammatory proteins and reduced EF are at high risk of impaired LV midwall mechanics 1 year after bariatric surgery.ClinicalTrials.gov identifier NCT01533142 February 15, 2012.

MeSH terms

  • Bariatric Surgery* / adverse effects
  • C-Reactive Protein
  • Female
  • Humans
  • Hypertension*
  • Leukocyte L1 Antigen Complex
  • Obesity / complications
  • Obesity, Morbid* / surgery
  • Risk Factors
  • Stroke Volume
  • Ventricular Dysfunction, Left*
  • Ventricular Function, Left

Substances

  • C-Reactive Protein
  • Leukocyte L1 Antigen Complex

Associated data

  • ClinicalTrials.gov/NCT01533142