BRIDGING THE GAP: A SYSTEMATIC REVIEW OF BARIATRIC SURGERY'S EFFECTS ON CARDIAC HEALTH

Main Article Content

Dr Muhammad Haider Ali
Dr Sania Malik
Dr Muhammad Jawad Zahid
Dr Mashhood Alam Khan
Dr Muhammad Saleem
Dr Shabeer ahmad
Dr Muhammad Waqas
Dr Hamza Khan Toru
Dr Aftab Faheem
Dr Aisha Farooq

Keywords

bariatric surgery, metabolic surgery, imaging, cardiac activity, cardiac structure, obesity cardiomyopathy.

Abstract

Objective: This study compares preoperative and post-operative cardiac imaging measures to examine the effects of bariatric surgery on heart shape and function in obese patients.


Methodology: Using PubMed, MedLine, Ovid, and Cinhal, this work searched the literature for bariatric, metabolic, weight loss, and obesity surgery as well as echocardiography, MRI, cardiac imaging, cardiac dimensions, & ventricular dimensions. Studies included had an initial follow-up of three months and reported on heart structural and function parameters obtained by MRI or echocardiography. Study excluded had conflicting or no preoperative or postoperative data. The Newcastle-Ottawa scale was used for quality assessment; PRISMA guidelines were followed for statistical analysis, which computed and pooled results using a model of random effects with 95% confidence intervals, weighted mean differences, and DerSimonian & Laird modelling. We looked at inter-study heterogeneity with the I2 statistic.


Results: Bariatric surgery greatly improves a number of cardiac indices, including left atrium diameter (1.967 mm, 95% CI 0.980-2.954), left ventricular end-diastolic volume (13.28 ml, 95% CI 5.22-21.34 ml), as well as left ventricular mass index (11.2, 95% confidence intervals (CI) 8.2-14.1%). Positive increases were noted for the left ventricular ejection fraction (1.198, 95% CI 0.050-2.347) and the E/A ratio (0.189, 95% CI 0.113–0.265).


Conclusion: In obese patients, bariatric surgery has been shown to have beneficial impacts on diastolic function, systolic function, and cardiac structure. The alteration of the enteric cardiac axis may be a contributing factor to these outcomes. However, future research endeavours should prioritize the acquisition of more robust evidence to precisely determine the most effective bariatric procedures for preventing and treating a diverse spectrum of obesity-related cardiac pathologies, in addition to further developing strategies for managing obesity cardiomyopathy.

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