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Abstract
Surgical weight loss (SWL) improves myocardial mechanics as measured by speckle-tracking imaging. However non-surgical versus SWL and the subsequent impact on myocardial function in overweight Asian subjects has not been evaluated. 66 patients underwent a 16-week lifestyle intervention (LSI) programme consisting of dietary interventions and exercise prescription. Echocardiography with speckle tracking was performed at baseline and post-intervention. This group was compared against a group of 12 subjects who had undergone bariatric surgery and a control group of 10 lean Asian subjects. A generalised structural equation model (gSEM) was constructed to ascertain the effect of modality of weight loss on strain parameters, adjusting for BMI. Participants attained significant weight loss after LSI (28.2 ± 2.66 kg/m2 vs. 25.8 ± 2.84 kg/m2, p = 0.001). This was associated with a non-significant trend towards improvement in strain parameters. SWL participants had significant improvement in the left ventricular global longitudinal strain (− 20.52 ± 3.34 vs. − 16.68 ± 4.15, p < 0.01) and left atrium reservoir strain (44.32 ± 14.23 vs. 34.3 ± 19.31, p = 0.02). Lean subjects had significantly higher strain parameters than overweight subjects. The gSEM model demonstrated surgical modality of weight loss as an independent predictor of improvement in strain parameters. Significant improvement in echocardiographic parameters were documented in patients who underwent bariatric surgery.
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1 National University Health System, Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore (GRID:grid.410759.e) (ISNI:0000 0004 0451 6143); National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431)
2 National University Health System, Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore (GRID:grid.410759.e) (ISNI:0000 0004 0451 6143)
3 National University Hospital, Department of Surgery, Singapore, Singapore (GRID:grid.412106.0) (ISNI:0000 0004 0621 9599)
4 National University Health System Singapore, Department of Medicine, Singapore, Singapore (GRID:grid.410759.e) (ISNI:0000 0004 0451 6143)
5 National University Health System, Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore, Singapore (GRID:grid.410759.e) (ISNI:0000 0004 0451 6143); National University of Singapore, Centre for Behavioural and Implementation Science Interventions, Yong Loo Lin School of Medicine, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431); Tan Tock Seng Hospital, Institute of Geriatrics and Active Ageing, Singapore, Singapore (GRID:grid.240988.f) (ISNI:0000 0001 0298 8161)
6 National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431)
7 National University Health System, Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore (GRID:grid.410759.e) (ISNI:0000 0004 0451 6143); National University of Singapore, Yong Loo Lin School of Medicine, Singapore, Singapore (GRID:grid.4280.e) (ISNI:0000 0001 2180 6431); National University Health System, Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore, Singapore (GRID:grid.410759.e) (ISNI:0000 0004 0451 6143); University of Otago, Christchurch Heart Institute, Christchurch, New Zealand (GRID:grid.29980.3a) (ISNI:0000 0004 1936 7830)
8 Northwestern University Feinberg School of Medicine, Division of Cardiology, Department of Medicine, Chicago, USA (GRID:grid.16753.36) (ISNI:0000 0001 2299 3507)