title: Favorable changes in arterial elasticity, left ventricular mass, and diastolic function after significant weight loss following laparoscopic sleeve gastrectomy in obese individuals.
abstract: BACKGROUND
  Obesity is accompanied by increased arterial stiffness, left ventricular (LV) hypertrophy, and diastolic dysfunction, all associated with a negative prognosis. The evolution of LV mass, function, and arterial elasticity after laparoscopic sleeve gastrectomy (LSG) was unknown, and this is what we have investigated.
  
  
  METHODS
  Thirty-four consecutive obese subjects (mean age, 39 ± 11 years; 35.2 % men), scheduled for LSG, were studied before, at 6 and 12 months after surgery.
  
  
  RESULTS
  The body mass index (BMI) decreased from 43.6 ± 11.9 to 32.1 ± 7.4 and to 28.9 ± 5.8 kg/m(2) at 6 and 12 months after surgery (all p < 0.05). The baseline LV mass index was correlated with age, BMI, waist circumference, blood glucose level, systemic hypertension stage, and with aortic distensibility, strain, and stiffness index (all p < 0.05). Aortic distensibility increased by 110 %, aortic strain by 58 %, and aortic stiffness index decreased by 88 % at 6 months after LSG (all p(6 months-baseline) < 0.05) and all the parameters had similar values at 12 months postoperatively (all p(12-6 months) = NS). LV hypertrophy prevalence decreased from 61.8 to 47.1 % and to 32.3 % at 6 and 12 months after surgery (all p < 0.05). The proportion of patients with LV diastolic dysfunction decreased from 52.9 to 23.5 % at 6 months (p(6 months-baseline) < 0.01) and to 20.6 % at 12 months postoperatively (p(12 -6 months)= 0.7).
  
  
  CONCLUSIONS
  Significant improvements of aortic elasticity and of LV diastolic function were recorded at 6 months, and they were maintained at 12 months after LSG. The LV hypertrophy showed also a favorable evolution: it has been slightly improved 6 months after surgery and further ameliorated 1 year postoperatively.
authors.affiliation: Bariatric and Metabolic Surgery Centre of Excellence, Ponderas Hospital, Str. Rãcari, nr. 6A, sector 3, Bucharest, Romania, madalina.iancu@gmail.com.
authors.forename: Mădălina E
authors.initials: ME
authors.lastname: Iancu
authors.forename: Cătălin
authors.initials: C
authors.lastname: Copăescu
authors.forename: Marinela
authors.initials: M
authors.lastname: Şerban
authors.forename: Carmen
authors.initials: C
authors.lastname: Ginghină
mesh_terms: D000328:Adult; D001018:Aortic Diseases / Q000503:physiopathology / Q000517:prevention & control*; D001794:Blood Pressure; D015992:Body Mass Index; D004452:Echocardiography; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome; D059289:Vascular Stiffness; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000517:prevention & control*; D015431:Weight Loss