The effects of bariatric surgery on cardiac function: a systematic review and meta-analysis

Abstract

Abstract Introduction Obesity is associated with alterations in cardiac structure and haemodynamics leading to cardiovascular mortality and morbidity. Culminating evidence suggests improvement of cardiac structure and function following bariatric surgery. Objective To evaluate the effect of bariatric surgery on cardiac structure and function in patients before and after bariatric surgery. Methods Systematic review and meta-analysis of studies reporting pre- and postoperative cardiac structure and function parameters on cardiac imaging in patients undergoing bariatric surgery. Results Eighty studies of 3332 patients were included. Bariatric surgery is associated with a statistically significant improvement in cardiac geometry and function including a decrease of 12.2% (95% CI 0.096–0.149; p < 0.001) in left ventricular (LV) mass index, an increase of 0.155 (95% CI 0.106–0.205; p < 0.001) in E/A ratio, a decrease of 2.012 mm (95% CI 1.356–2.699; p < 0.001) in left atrial diameter, a decrease of 1.16 mm (95% CI 0.62–1.69; p < 0.001) in LV diastolic dimension, and an increase of 1.636% (95% CI 0.706–2.566; p < 0.001) in LV ejection fraction after surgery. Conclusion Bariatric surgery led to reverse remodelling and improvement in cardiac geometry and function driven by metabolic and haemodynamic factors.