The Effect of Bariatric Surgery on Left Atrium Mechanical Activity, Left Atrial Strain, and Diastolic Function
Novelty in Biomedicine,
Vol. 14 No. 3 (2026),
25 August 2026
,
Page 127-132
https://doi.org/10.22037/nbm.v14i3.51927
Abstract
Background: As a widespread global health concern, obesity frequently results in cardiovascular complications. Bariatric surgery has emerged as an effective intervention for managing severe obesity in cases where conventional weight-loss methods have proven unsuccessful. This investigation aimed to evaluate alterations in left atrial (LA) mechanical activity, atrial strain parameters, and diastolic function following bariatric surgery.
Materials and Methods: In this quasi-experimental longitudinal study, patients scheduled for bariatric procedures at Imam Hossein Hospital (Tehran, Iran) between March 2021 and March 2022 were enrolled. Comprehensive echocardiographic assessments were performed pre- and post-operatively, followed by detailed statistical evaluation.
Results: The study cohort comprised 22 individuals with a mean age of 40.27 ± 9.79 years, predominantly female (72.2%). A substantial reduction in mean body mass index was documented, decreasing from 43.68 ± 5.17 kg/m² to 36.09 ± 4.94 kg/m² (p < 0.001). Among comorbidities, diabetes mellitus was most prevalent (31.8%). Postoperative assessments revealed significant reductions in multiple cardiac parameters (p < 0.05), including left ventricular end-diastolic and end-systolic dimensions, right ventricular diastolic diameter, LA dimensions, atrial volume, and pericardial adipose tissue. Concurrently, significant improvements were observed in septal and lateral É values, alongside enhanced LA reservoir and conduit functions (p < 0.05).
Conclusion: The results demonstrate that bariatric surgery produces favorable modifications in diastolic performance and left atrial dynamics. Additionally, the procedure positively influences functional parameters of both ventricular chambers.
- Metabolic Surgery
- Atrial Mechanics
- Cardiac Diastolic Function
- Morbid Obesity
How to Cite
References
1. Csige I, Ujvárosy D, Szabó Z, Lőrincz I, Paragh G, Harangi M, et al. The impact of obesity on the cardiovascular system. J Diabetes Res 2018;2018(1):3407306.
2. Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98-107.
3. Delgado V, Di Biase L, Leung M, Romero J, Tops LF, Casadei B, et al. Structure and function of the left atrium and left atrial appendage: AF and stroke implications. J Am Coll Cardiol. 2017;70(25):3157-72.
4. Thomas L, Marwick TH, Popescu BA, Donal E, Badano LP. Left atrial structure and function, and left ventricular diastolic dysfunction: JACC state-of-the-art review. J Am Coll Cardiol. 2019;73(15):1961-77.
5. Garcia-Labbé D, Ruka E, Bertrand OF, Voisine P, Costerousse O, Poirier P. Obesity and coronary artery disease: evaluation and treatment. Can J Cardiol. 2015;31(2):184-94.
6. Katta N, Loethen T, Lavie CJ, Alpert MA. Obesity and coronary heart disease: epidemiology, pathology, and coronary artery imaging. Curr Probl Cardiol. 2021;46(3):100655.
7. Alpert MA, Omran J, Mehra A, Ardhanari S. Impact of obesity and weight loss on cardiac performance and morphology in adults. Prog Cardiovasc Dis. 2014;56(4):391-400.
8. Lubbers ER, Price MV, Mohler PJ. Arrhythmogenic substrates for atrial fibrillation in obesity. Front Physiol. 2018;9:1482.
9. Hoit BD. Assessment of left atrial function by echocardiography: novel insights. Curr Cardiol Rep. 2018;20(10):96.
10. Karakurt A, Yildiz C, Yildiz A, Karabağ Y, Çağdaş M, Rencüzoğulları İ, et al. Early detection strain/strain rate and time to strain/strain rate abnormalities for left atrial mechanical function in hypertensive patients. Acta Cardiol. 2019;74(2):141-51.
11. Jasic-Szpak E, Marwick TH, Donal E, Przewlocka-Kosmala M, Huynh Q, Gozdzik A, et al. Prediction of AF in heart failure with preserved ejection fraction: incremental value of left atrial strain. J Cardiovasc Imaging. 2021;14(1):131-44.
12. Rasmussen SMA, Olsen FJ, Jørgensen PG, Fritz-Hansen T, Jespersen T, Gislason G, et al. Utility of left atrial strain for predicting atrial fibrillation following ischemic stroke. Int J Cardiovasc Imaging. 2019;35(9):1605-13.
13. Singh A, El Hangouche N, McGee K, Gong FF, Lentz R, Feinglass J, et al. Utilizing left atrial strain to identify patients at risk for atrial fibrillation on ibrutinib. Echocardiography. 2021;38(1):81-8.
14. Vasquez N, Ostrander BT, Lu D-Y, Ventoulis I, Haileselassie B, Goyal S, et al. Low left atrial strain is associated with adverse outcomes in hypertrophic cardiomyopathy patients. J Am Soc Echocardiogr. 2019;32(5):593-603. e1.
15. Potter EL, Ramkumar S, Kawakami H, Yang H, Wright L, Negishi T, et al. Association of asymptomatic diastolic dysfunction assessed by left atrial strain with incident heart failure. J Cardiovasc Imaging. 2020;13(11):2316-26.
16. Santos AB, Roca GQ, Claggett B, Sweitzer NK, Shah SJ, Anand IS, et al. Prognostic relevance of left atrial dysfunction in heart failure with preserved ejection fraction. Circ Heart Fail. 2016;9(4):e002763.
17. Lynch KT, Mehaffey JH, Hawkins RB, Hassinger TE, Hallowell PT, Kirby JL. Bariatric surgery reduces incidence of atrial fibrillation: A propensity score–matched analysis. Surg Obes Relat Dis. 2019;15(2):279-85.
18. Sarmiento-Cobos M, Valera R, Fonnegra CB, Alonso M, Rivera C, Montorfano L, et al. Ventricular conduction improvement after pericardial fat reduction triggered by rapid weight loss in subjects with obesity undergoing bariatric surgery. Surg Obes Relat Dis. 2022;18(2):288-94.
19. Yılmaz M, Altın C, Tekin A, Erol T, Arer İ, Nursal TZ, et al. Assessment of atrial fibrillation and ventricular arrhythmia risk after bariatric surgery by P wave/QT interval dispersion. Obes Surg. 2018;28(4):932-8.
20. Haider S, Tatari A, Galloway CE, Amjad MT, McElroy DM, Nwanguma OR, et al. MULTI-VARIABLE ANALYSIS OF ECHOCARDIOGRAPHIC PARAMETERS IN PATIENTS PRIOR TO AND AFTER GASTRIC SLEEVE SURGERY. J Am Coll Cardiol. 2020;75(11_Supplement_1):1651-.
21. Melenovsky V, Hwang S-J, Redfield MM, Zakeri R, Lin G, Borlaug BA. Left atrial remodeling and function in advanced heart failure with preserved or reduced ejection fraction. Circ Heart Fail. 2015;8(2):295-303.
22. Miyoshi H, Oishi Y, Mizuguchi Y, Iuchi A, Nagase N, Ara N, et al. Association of left atrial reservoir function with left atrial structural remodeling related to left ventricular dysfunction in asymptomatic patients with hypertension: evaluation by two-dimensional speckle-tracking echocardiography. Clin Exp Hypertens. 2015;37(2):155-65.
23. Welles CC, Ku IA, Kwan DM, Whooley MA, Schiller NB, Turakhia MP. Left atrial function predicts heart failure hospitalization in subjects with preserved ejection fraction and coronary heart disease: longitudinal data from the Heart and Soul Study. J Am Coll Cardiol. 2012;59(7):673-80.
24. Singh A, Addetia K, Maffessanti F, Mor-Avi V, Lang RM. LA strain for categorization of LV diastolic dysfunction. JACC Cardiovasc Imaging. 2017;10(7):735-43.
25. Cuspidi C, Sala C, Rescaldani M, Tadic M, Grassi G. Effects of bariatric surgery on right ventricular structure and function. J Cardiovasc Med (Hagerstown). 2014;15(10):731-7.
26. Vest AR, Patel P, Schauer PR, Satava ME, Cavalcante JL, Brethauer S, et al. Clinical and echocardiographic outcomes after bariatric surgery in obese patients with left ventricular systolic dysfunction. Circ Heart Fail. 2016;9(3):e002260.
27. Davarpasand T, Hosseinsabet A, Omidi F, Mohseni‐Badalabadi R. Interaction effect of myocardial infarction and obesity on left atrial functions. J Clin Ultrasound. 2021;49(5):431-41.
28. Hamo C, Wallace A, Shah AM, Florido R, Tcheugui JE, Matsushita K, et al. Correlation between echocardiographic measures and HS-CTNT levels pre-and post-bariatric surgery. J Am Coll Cardiol. 2020;75(11_Supplement_1):1988-.
29. Strzelczyk J, Kalinowski P, Zieniewicz K, Szmigielski C, Byra M, Styczyński G. The influence of surgical weight reduction on left atrial strain. Obes Surg. 2021;31(12):5243-50.
30. Hosseinsabet A, Mohseni-Badalabadi R, Jalali A. Two-dimensional speckle-tracking echocardiography evaluation of left atrial function according to glycemic state in patients with coronary artery disease. Cardiovasc Endocrinol Metab. 2017;6(3):101-8.
- Abstract Viewed: 25 times
- pdf Downloaded: 18 times