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Cardiovascular Disease and Adiposity · Journal article
Turk Kardiyoloji Dernegi Arsivi-archives of the Turkish Society of Cardiology · August 14, 2026
Well-designed and adequately powered for the question it asks.
This prospective cohort study of 100 adults with severe obesity undergoing bariatric surgery demonstrates that both sleeve gastrectomy and Roux-en-Y gastric bypass induce significant reverse cardiac remodeling at 6 months, with RYGB showing greater reductions in left ventricular mass and epicardial adipose tissue. Multivariable analysis indicates that functional improvement in myocardial deformation is driven primarily by metabolic improvement and inflammatory reduction rather than surgical technique alone.
Prospective observational cohort study. 100 adults with severe obesity (BMI > 35 kg/m²) undergoing primary bariatric surgery; mean age 35.9 years, 67% female; baseline characteristics comparable between groups.. Intervention: Sleeve gastrectomy (n=50) or Roux-en-Y gastric bypass (n=50). Compared with: Sleeve gastrectomy vs. Roux-en-Y gastric bypass. n = 100. Not stated.
RYGB associated with greater BMI reduction (−10.74 ± 2.42 vs. −9.32 ± 2.42 kg/m²; P = 0.004) RYGB showed greater structural reverse remodeling with LVMI reduction (median −12.0 vs. −6.5 g/m²·⁷; P < 0.001) EAT thickness reduction greater after RYGB (−1.20 vs. −0.70 mm; P = 0.014)
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These findings suggest that both bariatric procedures induce cardiac reverse remodeling, with RYGB achieving greater structural improvement. However, functional cardiac recovery appears driven by metabolic and inflammatory improvement rather than surgical technique, implying that optimization of glucose control and inflammatory markers may be key targets alongside weight loss for maximizing cardiac benefit.
Prospective comparative cohort study with standardized cardiac imaging and multivariable analysis demonstrating significant structural and functional reverse remodeling after bariatric surgery, with differential effects between procedures and mechanistic insights.
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Quoted from the source exactly as published.
These findings suggest that both bariatric procedures induce cardiac reverse remodeling, with RYGB achieving greater structural improvement. However, functional cardiac recovery appears driven by metabolic and inflammatory improvement rather than surgical technique, implying that optimization of glucose control and inflammatory markers may be key targets alongside weight loss for maximizing cardiac benefit.
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OBJECTIVE: Obesity is associated with characteristic cardiac remodeling, including left ventricular (LV) hypertrophy, concentric geometry, and subclinical myocardial dysfunction. Bariatric surgery induces reverse cardiac remodeling; however, it remains unclear whether structural and functional recovery differ between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and to what extent these changes are driven by weight loss versus metabolic and inflammatory mechanisms. METHOD: In this prospective observational cohort study, 100 adults with severe obesity (body mass index [BMI] > 35 kg/m²) undergoing primary bariatric surgery (SG, n = 50; RYGB, n = 50) were evaluated at baseline and six months postoperatively. Clinical, metabolic, inflammatory, and echocardiographic parameters-including left ventricular mass index (LVMI), epicardial adipose tissue (EAT) thickness, diastolic function, and global longitudinal strain (GLS)-were assessed using standardized transthoracic echocardiography with speckle-tracking analysis. Multivariable regression identified independent predictors of structural (ΔLVMI) and functional (ΔGLS) improvement. RESULTS: Baseline characteristics were comparable between groups (mean age 35.9 years; 67% female; BMI 47.1 kg/m²). Both procedures resulted in significant improvements in anthropometric, metabolic, inflammatory, and cardiac parameters. RYGB was associated with greater reductions in BMI (-10.74 +- 2.42 vs. -9.32 +- 2.42 kg/m²; P = 0.004), glycated hemoglobin (HbA1c) (median -1.40% vs. -0.90%; P = 0.007), and C-reactive protein (CRP) (P = 0.029). Structural reverse remodeling was more pronounced following RYGB, with greater reductions in LVMI (median -12.0 vs. -6.5 g/m²·⁷; P < 0.001) and EAT thickness (-1.20 vs. -0.70 mm; P = 0.014). GLS improved in both groups (-2.33% vs. -1.40%; P = 0.031). However, multivariable analysis demonstrated that improvement in GLS was independently associated with baseline GLS, reduction in LV mass, and improvements in HbA1c and CRP, rather than the type of surgical procedure. CONCLUSION: Bariatric surgery leads to significant reverse cardiac remodeling in patients with severe obesity. RYGB is associated with greater structural regression, whereas improvement in myocardial deformation appears to be primarily driven by metabolic improvement and inflammatory changes rather than surgical technique. These findings suggest that cardiac recovery reflects an integrated process involving structural, metabolic, and inflammatory restoration beyond weight loss alone.
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