title: Ventricular remodelling post-bariatric surgery: is the type of surgery relevant? A prospective study with 3D speckle tracking.
abstract: OBJECTIVE
  The aim of the study was to examine ventricular remodelling in patients free of cardiac risk factors, before, and 6 months post-bariatric surgery with the new imaging modality of three-dimensional (3D) strain and the comparison of two surgical techniques: sleeve gastrectomy vs. gastric bypass.
  
  
  RESULTS
  Fifty-two consecutive patients referred to the Bariatric Services of Imperial College NHS Trust were examined with conventional 2D and 3D strain echocardiography, prior to and 6 months after bariatric surgery. They were all free from cardiac disease. The study cohort's mean age was 44.2 ± 8.7 years and body mass index of 42.4 ± 4.6 g/m(2) prior to surgery. Eighteen patients (34.6%) underwent laparoscopic sleeve gastrectomy, and 34 laparoscopic gastric bypass. On 3D speckle tracking, there was significant reverse remodelling post-bariatric surgery [left ventricular (LV) ejection fraction (EF): pre-surgery: 59 ± 8% vs. post-surgery: 67 ± 7%, P < 0.001 and right ventricular (RV) EF: pre-surgery: 60 ± 9% vs. post-surgery: 68 ± 8.2%, P = 0.0001]. Furthermore, there was significant regression of mass (LV mass: pre-surgery: 111 ± 23.5 g vs. post-surgery: 92.8 ± 15.5 g and RV mass: pre-surgery: 95.2 ± 19.8 vs. post-surgery: 67.3 ± 16.3, P < 0.001). RV and LV global strain improved 6 months post-bariatric surgery: global RV strain: pre-surgery -11.7 ± 4 vs. post-surgery -17.52 ± 3.7, P < 0.001; global LV strain: pre-surgery: -20.2 ± 1.7 vs. post-surgery: -26.5 ± 1.86, P < 0.001. Sleeve gastrectomy and gastric bypass had comparable effects.
  
  
  CONCLUSIONS
  Bariatric surgery has an important effect in reverse LV and RV remodelling and it substantially improves RV longitudinal strain.
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Thomas E
authors: TE
authors: Kaier
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Douglas
authors: D
authors: Morgan
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Julia
authors: J
authors: Grapsa
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Ozan M
authors: OM
authors: Demir
authors: Department of Diabetes, St Bartholomew's Hospital, London, UK.
authors: Stavroula A
authors: SA
authors: Paschou
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Shweta
authors: S
authors: Sundar
authors: Department of Bariatric Surgery and Anesthesia, St Mary's Hospital, Imperial College NHS Trust, London, UK.
authors: Sherif
authors: S
authors: Hakky
authors: Department of Bariatric Surgery and Anesthesia, St Mary's Hospital, Imperial College NHS Trust, London, UK.
authors: Sanjay
authors: S
authors: Purkayastha
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Susan
authors: S
authors: Connolly
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK.
authors: Kevin F
authors: KF
authors: Fox
authors: Department of Bariatric Surgery and Anesthesia, St Mary's Hospital, Imperial College NHS Trust, London, UK.
authors: Ahmed
authors: A
authors: Ahmed
authors: Department of Anaesthesia, Charing Cross Hospital, Imperial College NHS Trust, London, UK.
authors: Jonathan
authors: J
authors: Cousins
authors: Department of Cardiovascular Sciences, Hammersmith & Charing Cross Hospitals, Imperial College NHS Trust, London, UK petros@imperial.ac.uk.
authors: Petros
authors: P
authors: Nihoyannopoulos
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D011446:Prospective Studies; D020257:Ventricular Remodeling
keywords: Bariatric surgery; Obesity; Remodelling; Speckle tracking; Three-dimensional