Left ventricular (LV) changes associated with obesity, including LV hypertrophy and impaired LV function, have been shown to be reverted by bariatric surgery. Little is known about the effects of bariatric procedures on right ventricle (RV). We analyzed the literature in order to provide a comprehensive information on RV structural and functional changes, as assessed by imaging techniques, after bariatric surgery.
Methods and results
The studies were identified by the following search terms: ‘bariatric surgery’, ‘obesity’, ‘left ventricle’, ‘right ventricle’, ‘left ventricular hypertrophy’, ‘right ventricular hypertrophy’, ‘cardiac hypertrophy’, ‘ventricular dysfunction’, ‘echocardiography’, ‘magnetic resonance imaging’ and ‘cardiac imaging techniques’.
In a pooled population of 537 obese patients with preserved systolic function enrolled in eight studies, bariatric surgery induced beneficial effects on RV morphology and function; the procedures reverted obesity-related right ventricular hypertrophy as suggested by a significant decrease in RV mass, and improved systolic and diastolic RV performance as assessed by traditional and newer echocardiographic indexes. Decrements in body mass index and improvement in obstructive sleep apnea were major factors independently related to the improved RV structure and function.
The present review shows that bariatric surgery exerts beneficial effects on RV structure and function in morbidly obese patients. As RV changes are independent predictors of outcomes, improvement of RV structure and function may contribute to the cardioprotective effects of bariatric surgery.