The role of echocardiographic parameters and serum galectin-3 levels in detection of potential cardiac reverse remodelling after obesity surgery

Purpose: Obesity is a global health problem with an increasing prevalence, which shortens life expectancy due to its co morbidities. Obesity can cause changes in cardiac morphology that predisposes to cardiac dysfunction. The frequency of using bariatric surgical methods in the treatment of obesity is increasing day by day. Laparoscopic sleeve gastrectomy (LSG) is one of the most important surgical options in the treatment of morbid obesity today. In our study, we aimed to evaluate the effect of LSG on cardiac reverse remodeling and cardiac fibrosis. Material and method: 72 consecutive obesity patients who had LSG surgery due to obesity at Çukurova University Medical Faculty Balcalı Hospital and 72 healthy individuals were examined between 2020 and 2022. Demographic data, anthropometric measurements, laboratory characteristics, Galectin-3 (Gal-3) and echocardiographic parameters of the patients and the individuals in the healthy group were evaluated. Findings: The mean age of the patients who were included in the study was 34.7±10.2 years, 105 (72.9%) of them were female. Postoperative mean body mass index (BMI) decreased from 43.6±4.2 kg/m² to 29.4±3.8 kg/m². A statistically significant decrease was observed in body weight loss, BMI and body surface area (BSA) in the surgical group. Besides, there was a significant increase in mean Mitral E peak velocity (p <0.001) and E/A ratio (p <0.001) in postoperative follow-up and there was a significant decrease in left atrial (LA) size (p=0.015), left ventricular end-diastolic diameter (LVEDD) (p <0.001 ), left ventricular mass (LVM) (p <0.001), LA volume (LAV) (p <0.001), LA volume index (LAVI) (p <0.001) and mean Mitral A peak velocity (p <0.001). In the patient group, a statistically insignificant decrease was observed in the Gal-3 value after the surgery compared to the preoperative period (9.0±4.6 vs. 7.8±3.8, p=0.146). Conclusion: Effective weight loss was achieved in the short term with LSG. Significant improvements were detected in both systolic and diastolic functions with LSG. During the 6-month follow-up after surgery, Gal-3 level was not found to be significant. Long-term follow-up may be required to evaluate the change of LSG over Gal-3. Key words: Obesity, Laparoscopic Sleeve Gastrectomy, Galectin-3, Left Atrial Volume Index, Left Ventricular Mass Index.