Weight Loss with Sleeve Gastrectomy in Obese Type 2 Diabetes Mellitus: Impact on Cardiac Function

Diabetic cardiomyopathy is an increasingly prevalent health issue, with no specific management options. We examined the impact of weight loss with sleeve gastrectomy on diabetic cardiomyopathy. Eight obese patients with type 2 diabetes undergoing sleeve gastrectomy had left ventricular (LV) systolic and diastolic function assessed by global longitudinal strain (GLS) and septal early diastolic velocity (e') using echocardiography, before and 9 months after surgery. Following surgery, mean weight loss was 28.0 +/- 16 kg; body mass index (BMI) decreased from 44 +/- 9 to 35 +/- 6 kg/m(2) (p < 0.001). Glycaemic control improved with glycated haemoglobin (HbA1c) improving from 9.2 % at baseline to 6.7 % at follow-up (p = 0.002), with a corresponding improvement in LV GLS from -13.2 +/- 3.7 to -19.7 +/- 2.2 % (p < 0.001), and LV ejection fraction from 60 +/- 5 to 70 +/- 4 % (p < 0.001). Improvement in GLS was associated with the amount of weight lost (rho = 0.81, p = 0.015). LV septal e' velocities increased, and LV filling pressures decreased after surgery. Weight loss with sleeve gastrectomy in obese patients with type 2 diabetes is effective in improving glycaemic control in subjects with type 2 diabetes and results in significant improvement in both systolic and diastolic myocardial function.