Rabia Eker AKILLI, Ömer TEPE, Onur Sinan DEVECI, Orçun YALAV, Ali DENİZ, Haydar Ali CANDAN
Çukurova Anestezi ve Cerrahi Bilimler Dergisi - 2026;9(2):487-496
Aim: Obesity is associated with structural and functional cardiac abnormalities, including left ventricular hypertrophy, diastolic dysfunction, and subclinical myocardial impairment. Global longitudinal strain (GLS) is a sensitive marker for detecting early myocardial impairment before changes in left ventricular ejection fraction (LVEF) occur. This study aimed to evaluate the early effects of laparoscopic sleeve gastrectomy (LSG) on cardiac remodeling and myocardial mechanics using conventional and speckle-tracking echocardiography. Methods: This retrospective single-center study included 66 patients with severe obesity who underwent LSG. Clinical, metabolic, and echocardiographic parameters were evaluated before surgery and at a mean follow-up of approximately 3-6 months. Conventional and speckle-tracking echocardiography were used to assess left ventricular structure and myocardial mechanics. Preoperative and postoperative parameters were compared using paired-samples t-test. Results: The mean age was 36.9 +/- 11.7 years, and 75.8% of patients were female. Following LSG, significant reductions were observed in body weight, body mass index, and blood pressure (all p<0.001), accompanied by improvements in glucose and lipid metabolism. Echocardiographic evaluation revealed significant reductions in left atrial volume, left ventricular dimensions and mass, as well as improved diastolic function parameters, including E/A and E/e? ratios (both p<0.001). Despite no significant change in LVEF, GLS improved significantly after surgery (20.0 +/- 2.7% vs. 21.8 +/- 2.4%, p<0.001), indicating early recovery of subclinical myocardial dysfunction. Conclusion: LSG is associated with significant early reverse cardiac remodeling and improvement in subclinical myocardial dysfunction. GLS appears to be more sensitive than conventional echocardiographic systolic indices for detecting early myocardial recovery following bariatric surgery.
