title: Cardiac remodeling in obese patients after laparoscopic sleeve gastrectomy.
abstract: BACKGROUND
  Obesity is associated with high morbidity and represents an increasing health care problem worldwide. Laparoscopic sleeve gastrectomy (LSG) has been used effectively for weight loss and co-morbidity remission. In this retrospective study, we evaluated cardiac reverse remodeling at medium-term follow-up by echocardiography, the amount of cardiovascular medications, and the impact of co-morbidities after sleeve gastrectomy.
  
  
  METHODS
  Altogether, 16 obese patients (4 men, 12 women; 46.4 ± 10.3 years) underwent complete clinical evaluation, laboratory tests, and color Doppler/tissue Doppler imaging echocardiography preoperatively and 12-20 months after bariatric surgery.
  
  
  RESULTS
  Body weight (mean body mass index) was significantly reduced (from 44.8 ± 8.0 to 31.2 ± 7.8 kg/m2; p = 0.001). Lipid profile significantly improved: total cholesterol and triglycerides decreased (respectively: 215.5 ± 53.8 vs. 205.3 ± 46.6 mg/dl and 184.9 ± 109.3 vs. 116.1 ± 49.9 mg/dl, both p ≤ 0.05), and high-density lipoprotein increased (43.1 ± 10.9 vs. 51.4 ± 12.8 mg/dl, p = 0.005). Systolic blood pressure significantly decreased (from 133.0 ± 17.1 to 120.6 ± 13.7 mmHg; p = 0.04). Diabetes remission was complete in five of six patients (83%) and sleep apnea in four of five (80 %). Echocardiography showed significantly reduced interventricular septum and posterior wall thickness (11.3 ± 1.8 to 9.4 ± 2.1 mm and 10.4 ± 1.7 to 8.6 ± 1.9 mm, respectively; both p < 0.007) and reduced left ventricular mass (absolute value and indexed by height, respectively: 222.41 ± 78.2 to 172.75 ± 66.3 g (p = 0.003) and 55.9 ± 14.3 to 43.8 ± 17.2 g/m(2.7) (p = 0.0004). Antihypertensive drug intake was significantly reduced (p = 0.03), as shown by the 10-year Framingham Risk Score (from 14.2 ± 9.3 to 8.3 ± 9.5%, p = 0.003).
  
  
  CONCLUSIONS
  Sleeve gastrectomy is associated with marked improvement in terms of weight loss, lipid profile, type 2 diabetes, sleep apnea, hypertension, and left ventricular hypertrophy, with a significantly reduced Framingham Risk Score.
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso Della Repubblica 79, 04100, Latina, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Cavarretta
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casella
authors.forename: Benedetto
authors.initials: B
authors.lastname: Calì
authors.forename: Carmelisa
authors.initials: C
authors.lastname: Dammaro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.forename: Angelo
authors.initials: A
authors.lastname: Iossa
authors.forename: Frida
authors.initials: F
authors.lastname: Leonetti
authors.forename: Giacomo
authors.initials: G
authors.lastname: Frati
authors.forename: Nicola
authors.initials: N
authors.lastname: Basso
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods; D015992:Body Mass Index; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000503:physiopathology / Q000517:prevention & control; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008075:Lipoproteins, HDL / Q000032:analysis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000502:physiology*; D015431:Weight Loss; D055815:Young Adult
chemical_list: D008075:Lipoproteins, HDL