Recently, there has been mounting clinical evidence supporting the metabolic and weight-loss benefits of bariatric surgery for obese patients, which leads to improved cardiac structure. However, its effectiveness in enhancing the cardiac function of heart failure patients remains controversial.
A recent study published in Obesity Surgery found bariatric surgery to have beneficial cardiac effects on non-HFpEF (heart failure and preserved ejection fraction) obese patients. However, it did not substantially improve the pooled analysis of cardiac parameters. The extent of improvement may be influenced by factors such as the patient's baseline age and BMI and BMI loss extent. Shi-jing Lu et al. led the study.
This meta-analysis assessed BS's effect on cardiac function by examining LVEF (left ventricular ejection fraction) and NYHA (New York Heart Association) changes in non-HFpEF patients post-surgery.
Articles were sourced from PubMed and Embase, starting from their inception to December 9, 2022, using the Minors scale to evaluate their quality. The study included patients with non-HFpEF and severe obesity, requiring pre-operative and post-operative values of LVEF or NYHA to be reported.
Important points of consideration from the study include:
· Nine studies (146 patients) were included, with a final result showing improved cardiac functional parameters in non-HFpEF patients.
· Following the mean follow-up time of 15.8 months, the mean NYHA decreased by 0.59, and the mean LVEF increased by 7.49%.
In conclusion, bariatric surgery is associated with improved cardiac parameters in patients with non-HFpEF (heart failure and preserved ejection fraction). The extent of BS on cardiac functional improvement may relate to baseline BMI, age, and extent of BMI loss.
Bariatric surgery positively influences the cardiac function of non-HFpEF patients with obesity, they said.
PhD research initiation program of Liaoning Province, 2022-BS-358, funded the study.
Reference:
Lu, Sj et al. Evidence of Bariatric Surgery Benefits Cardiac Function in Non-HFpEF Patients with Obesity: a Meta-Analysis. OBES SURG 33, 3353–3361 (2023). https://doi.org/10.1007/s11695-023-06670-8