The Impact of Bariatric Surgery on Reverse Cardiac Remodeling and Serum Galectin-3 Levels

Öz

Abstract Aim: We aimed to investigate the effect of laparoscopic sleeve gastrectomy (LSG) on cardiac reverse remodeling and fibrosis in obese patients. Methods: This prospective study included 72 consecutive patients who underwent LSG for morbid obesity and 72 age- and sex-matched healthy controls between 2020 and 2022. Clinical and echocardiographic evaluations, including serum Galectin-3 (Gal-3) levels and anthropometric measurements, were performed at baseline and at the 6th month postoperatively. Results: There was a significant increase in the mean mitral E peak velocity (p<0.001) and E/A ratio (p <0.001), as well as a significant decrease in the left atrial (LA) diameter (p=0.015), left ventricular end-diastolic diameter (LVEDD) (p<0.001), left ventricular (LV) mass (p<0.001), left atrial volume (LAV) (p<0.001), left atrial volume index (LAVI) (p<0.001), and mean mitral A peak velocity (p<0.001). In the patient group, a non-significant decrease was observed in the Gal-3 levels postoperatively compared with the preoperative levels (p=0.146). Conclusion: Our findings suggest that LSG is a highly effective intervention for improving cardiac structure and function in morbidly obese patients, contributing significantly to reverse cardiac remodeling. The lack of statistically significant decrease in galectin-3 levels (p=0.146) may be due to the fact that the fibrosis process takes longer to reverse than the structural changes, or possibly due to the sample size. Keywords: Galectin-3, Obesity, laparoscopic sleeve gastrectomy, LV mass index, reverse cardiac remodeling.

Anahtar Kelimeler

• Galectin-3
• Obesity
• laparoscopic sleeve gastrectomy
• LV mass index
• reverse cardiac remodeling.

Destekleyen Kurum

None

Etik Beyan

Informed consent was obtained from all patients. This study was approved by the Cukurova University, Non-Interventional Research Ethics Committee (No.: 103, Date: 03/09/2020).

Teşekkür

None

Bariatrik Cerrahinin Ters Kardiyak Yeniden Şekillenme ve Serum Galektin-3 Düzeyleri Üzerindeki Etkisi

Öz

Özet Amaç: Bu çalışmada, obez hastalarda laparoskopik sleeve gastrektominin (LSG) kardiyak ters yeniden şekillenme ve fibroz üzerindeki etkisini araştırmayı amaçladık. Yöntem: Bu prospektif çalışmaya, 2020 ile 2022 yılları arasında morbid obezite nedeniyle LSG geçiren ardışık 72 hasta ve yaş ve cinsiyet açısından eşleştirilmiş 72 sağlıklı kontrol dahil edildi. Serum Galektin-3 (Gal-3) düzeyleri ve antropometrik ölçümler de dahil olmak üzere klinik ve ekokardiyografik değerlendirmeler, başlangıçta ve ameliyat sonrası 6. ayda yapıldı. Sonuçlar: Ortalama mitral E tepe hızında (p<0.001) ve E/A oranında (p <0.001) anlamlı bir artış, ayrıca sol atriyum (LA) çapında (p=0.015), sol ventrikül diyastol sonu çapında (LVEDD) (p<0.001), sol ventrikül (LV) kütlesinde (p<0.001), sol atriyum hacminde (LAV) (p<0.001), sol atriyum hacim indeksinde (LAVI) (p<0.001) ve ortalama mitral A tepe hızında (p<0.001) anlamlı bir azalma gözlendi. Hasta grubunda, ameliyat sonrası Gal-3 düzeylerinde ameliyat öncesi düzeylere kıyasla anlamlı olmayan bir azalma gözlendi (p=0.146). Sonuç: Bulgularımız, LSG'nin morbid obez hastalarda kalp yapısını ve fonksiyonunu iyileştirmede oldukça etkili bir müdahale olduğunu ve kardiyak yeniden şekillenmenin tersine çevrilmesine önemli ölçüde katkıda bulunduğunu göstermektedir. Galektin-3 düzeylerinde istatistiksel olarak anlamlı bir azalmanın olmaması (p=0.146), fibrozis sürecinin yapısal değişikliklerden daha uzun sürede tersine dönmesinden veya örneklem büyüklüğünden kaynaklanıyor olabilir. Anahtar kelimeler: Galektin-3, obezite, laparoskopik tüp mide ameliyatı, sol ventrikül kütle indeksi, ters kardiyak yeniden şekillenme.

Anahtar Kelimeler

• Galektin-3
• obezite
• laparoskopik tüp mide ameliyatı
• sol ventrikül kütle indeksi
• ters kardiyak yeniden şekillenme.

Destekleyen Kurum

Yok

Etik Beyan

Tüm hastalardan bilgilendirilmiş onam alınmıştır. Bu çalışma Çukurova Üniversitesi, Girişimsel Olmayan Araştırmalar Etik Kurulu tarafından onaylanmıştır (No.: 103, Tarih: 03/09/2020).

Teşekkür

Yok

Kaynakça

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