Impact of Body Mass Index >50 on Cardiac Structural and Functional Characteristics and Surgical Outcomes After Bariatric Surgery

Body mass index (BMI) ≥50.0 kg/m² has been associated with increased surgical complications and mortality. We assessed echocardiographic characteristics and bariatric surgery complications of patients with BMI ≥50.0 kg/m² vs. those in less severe obesity.

A retrospective analysis in patients who underwent gastric bypass was performed. Pre-surgery structural characteristics analyzed included left atrial dimension (LA), left ventricle mass (LVM), LVM indexed for height^2.7 (LVMI), and LV hypertrophy (LVH). Functional characteristics included LV diastolic and systolic function. Degree of obesity was correlated with cardiac parameters, comorbidities, and surgical complications. Data on 312 patients (75.3 % women, age 39.3 ± 0.6 years, BMI 50.2 ± 0.5 kg/m²) were analyzed. Cardiac parameters on the basis of BMI (<50 kg/m² vs. ≥50 kg/m²) were LA 39.6 ± 4.8 vs. 41.9 ± 5.2 mm, LVM 161 ± 46 vs. 194 ± 56 g, LVMI 43.6 ± 0.9 vs. 51.8 ± 1.3 g/ht^2.7, and systolic pulmonary pressure 43.7 ± 10.1 vs. 50.5 ± 11.3 mmHg, respectively (all p < 0.001). LVMI was correlated with BMI (p < 0.001), 2-h glucose on a glucose tolerance test (p = 0.01), and ejection fraction (p = 0.01). Surgical complications were not different among groups. Presence of LVH was independently associated with BMI ≥50 kg/m² and female sex, after adjusting for age, diabetes, hypertension, and pulmonary hypertension.

Body mass index ≥50 kg/m² was independently associated with female sex and LVH but not with hypertension, diabetes, or a higher rate of surgical complications.