title: Weight Loss with Sleeve Gastrectomy in Obese Type 2 Diabetes Mellitus: Impact on Cardiac Function.
abstract: BACKGROUND
  Diabetic cardiomyopathy is an increasingly prevalent health issue, with no specific management options. We examined the impact of weight loss with sleeve gastrectomy on diabetic cardiomyopathy.
  
  
  METHODS
  Eight obese patients with type 2 diabetes undergoing sleeve gastrectomy had left ventricular (LV) systolic and diastolic function assessed by global longitudinal strain (GLS) and septal early diastolic velocity (e') using echocardiography, before and 9 months after surgery.
  
  
  RESULTS
  Following surgery, mean weight loss was 28.0 ± 16 kg; body mass index (BMI) decreased from 44 ± 9 to 35 ± 6 kg/m(2) (p < 0.001). Glycaemic control improved with glycated haemoglobin (HbA1c) improving from 9.2% at baseline to 6.7% at follow-up (p = 0.002), with a corresponding improvement in LV GLS from -13.2 ± 3.7 to -19.7 ± 2.2% (p < 0.001), and LV ejection fraction from 60 ± 5 to 70 ± 4% (p < 0.001). Improvement in GLS was associated with the amount of weight lost (ρ = 0.81, p = 0.015). LV septal e' velocities increased, and LV filling pressures decreased after surgery.
  
  
  CONCLUSIONS
  Weight loss with sleeve gastrectomy in obese patients with type 2 diabetes is effective in improving glycaemic control in subjects with type 2 diabetes and results in significant improvement in both systolic and diastolic myocardial function.
authors.affiliation: Department of Cardiology, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, 1871, Australia. melissa@unsw.edu.au.|University of New South Wales, Sydney, NSW, Australia. melissa@unsw.edu.au.
authors.forename: Melissa
authors.identifier: http://orcid.org/0000-0002-1856-749X
authors.initials: M
authors.lastname: Leung
authors.affiliation: Department of Cardiology, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, 1871, Australia. mikey_xie@hotmail.com.|University of New South Wales, Sydney, NSW, Australia. mikey_xie@hotmail.com.|Liverpool Diabetes Collaborative Research Unit, Ingham Institute, Liverpool, Sydney, Australia. mikey_xie@hotmail.com.
authors.forename: Mikey
authors.initials: M
authors.lastname: Xie
authors.affiliation: Life Weight Loss Centre, Liverpool, Sydney, Australia. ekdurmush@gmail.com.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Durmush
authors.affiliation: Department of Cardiology, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, 1871, Australia. d.leung@unsw.edu.au.|University of New South Wales, Sydney, NSW, Australia. d.leung@unsw.edu.au.
authors.forename: Dominic Y
authors.initials: DY
authors.lastname: Leung
authors.affiliation: University of New South Wales, Sydney, NSW, Australia. vincent.wong@sswahs.nsw.gov.au.|Liverpool Diabetes Collaborative Research Unit, Ingham Institute, Liverpool, Sydney, Australia. vincent.wong@sswahs.nsw.gov.au.
authors.forename: Vincent W
authors.initials: VW
authors.lastname: Wong
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D058065:Diabetic Cardiomyopathies / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004452:Echocardiography; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D016277:Ventricular Function, Left / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology
keywords: Bariatric surgery; Cardiac function; Type 2 diabetes mellitus