PMID- 27431666
OWN - NLM
STAT- MEDLINE
DCOM- 20171120
LR  - 20201216
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 27
IP  - 2
DP  - 2017 Feb
TI  - Early Reverse Cardiac Remodeling Effect of Laparoscopic Sleeve Gastrectomy.
PG  - 364-375
LID - 10.1007/s11695-016-2301-2 [doi]
AB  - BACKGROUND: This study evaluated the early postoperative benefits of laparoscopic 
      sleeve gastrectomy (LSG) on the left ventricular (LV) function and left atrial 
      (LA) structural, mechanical, and electrical functions in severely obese patients. 
      METHODS: Thirty-two patients with severe obesity who were consecutively scheduled 
      for LSG and 30 healthy controls were included in the study. LV global 
      longitudinal strain (LGS), peak atrial longitudinal strain (PALS), and strain 
      rates (S-Sr, E-Sr, and A-Sr) of the lateral and septal LA walls, and intra- and 
      interatrial dyssynchrony periods for all subjects were evaluated using strain 
      echocardiography. The measurements were repeated in patients 1 month after 
      surgery. RESULTS: LGS of the LV was significantly depressed in the patient group 
      compared with the control group (p < 0.001). LA peak septal and lateral wall 
      strain values were significantly lower in patients than in controls (both p 
      values <0.001). LA intra- and interatrial dyssynchrony periods were longer in 
      patients than in controls (p = 0.012 and p = 0.004, respectively). LGS 
      significantly improved after LSG (p < 0.001). Significant reductions were noted 
      in the LA antero-posterior diameter (p < 0.001), LA volume index (LAVI, 
      p = 0.001), and in the mitral velocity to the early diastolic velocity of the 
      mitral annulus ratio (E/e' ratio, p = 0.046). The PALS of the septal and lateral 
      LA walls significantly increased (p = 0.001 and p < 0.001, respectively). S-Sr, 
      E-Sr, and A-Sr values of the septal LA wall (p = 0.049, p < 0.001, and p = 0.001, 
      respectively) and the lateral LA wall (p = 0.009, p = 0.007, and p = 0.002, 
      respectively) significantly improved postoperatively. Intra- and interatrial 
      dyssynchrony significantly decreased (p = 0.001 and p < 0.001, respectively). 
      Weight loss positively correlated with changes in LGS (R = 0.39, p = 0.039), LAVI 
      (R = 0.39, p = 0.034), intra-atrial dyssynchrony (R = 0.45, p = 0.021), 
      interatrial dyssynchrony (R = 0.42, p = 0.038), septal LA wall peak strain 
      (R = 0.44, p = 0.027), lateral LA wall peak strain (R = 0.46, p = 0.017), septal 
      LA wall A-Sr (R = 0.43, p = 0.028), and lateral LA wall A-Sr (R = 0.46, 
      p = 0.019). The comparison of postoperative findings of the patients with 
      controls revealed that the LA diameter, both LA volume and volume index (LAVI), 
      E/e' ratio, S-Sr and E-Sr of both lateral and septal LA walls, intra- and 
      interatrial LA dyssynchrony of the patient group became similar to the control 
      group (all p value >0.05). Postoperative A-Sr values of both LA walls (both p 
      value <0.001) were higher in patients than controls. CONCLUSION: The benefits of 
      LSG on LV and LA function may be observed even in the early postoperative phase. 
      The resulting weight loss correlates with LV and LA reverse remodeling in 
      severely obese patients.
FAU - Tuluce, Kamil
AU  - Tuluce K
AD  - Department of Cardiology, Karsiyaka State Hospital, Izmir, Turkey. 
      kamiltuluce@gmail.com.
FAU - Kara, Cemal
AU  - Kara C
AD  - Department of General Surgery, Karsiyaka State Hospital, Izmir, Turkey.
FAU - Tuluce, Selcen Yakar
AU  - Tuluce SY
AD  - Department of Cardiology, Izmir Katip Celebi University Ataturk Training and 
      Research Hospital, Izmir, Turkey.
FAU - Cetin, Nurullah
AU  - Cetin N
AD  - Department of Cardiology, Karsiyaka State Hospital, Izmir, Turkey.
FAU - Topaloglu, Caner
AU  - Topaloglu C
AD  - Department of Cardiology, Karsiyaka State Hospital, Izmir, Turkey.
FAU - Bozkaya, Yasemin Turhan
AU  - Bozkaya YT
AD  - Department of Cardiology, Karsiyaka State Hospital, Izmir, Turkey.
FAU - Saklamaz, Ali
AU  - Saklamaz A
AD  - Department of Internal Medicine, Izmir University Faculty of Medicine, Division 
      of Endocrinology and Metabolism, Izmir, Turkey.
FAU - Cinar, Cahide Soydas
AU  - Cinar CS
AD  - Department of Cardiology, Ege University Faculty of Medicine, Izmir, Turkey.
FAU - Ergene, Oktay
AU  - Ergene O
AD  - Department of Cardiology, Dokuz Eylul Faculty of Medicine, Izmir, Turkey.
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Atrial Remodeling
MH  - Echocardiography/methods
MH  - Female
MH  - *Gastrectomy/methods/rehabilitation
MH  - Heart Atria/pathology/physiopathology/surgery
MH  - Humans
MH  - Laparoscopy/methods/rehabilitation
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/complications/physiopathology/*surgery
MH  - Postoperative Period
MH  - Ventricular Dysfunction, Left/etiology/physiopathology/*surgery
MH  - Ventricular Function, Left
MH  - *Ventricular Remodeling
MH  - Young Adult
OTO - NOTNLM
OT  - Atrial functions
OT  - Cardiac remodeling
OT  - Laparoscopic sleeve gastrectomy
OT  - Obesity
OT  - Strain imaging
EDAT- 2016/07/20 06:00
MHDA- 2017/11/29 06:00
CRDT- 2016/07/20 06:00
PHST- 2016/07/20 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2016/07/20 06:00 [entrez]
AID - 10.1007/s11695-016-2301-2 [pii]
AID - 10.1007/s11695-016-2301-2 [doi]
PST - ppublish
SO  - Obes Surg. 2017 Feb;27(2):364-375. doi: 10.1007/s11695-016-2301-2.