Effects of Weight Loss After Gastric Bypass on Right and Left Ventricular Function Assessed by Tissue Doppler Imaging

To evaluate the effects of substantial weight loss on tissue Doppler imaging parameters of right ventricular (RV) and left ventricular (LV) systolic and diastolic function, we performed standard echocardiography and tissue Doppler imaging in 17 patients with severe obesity before and after gastric bypass. Patients lost 39 ± 10 kg over 7.6 ± 3.6 months. Adjusted LV mass decreased (134 ± 41 to 119 ± 31 kg/m, p = 0.031). After weight loss, the ratios of early-to-late diastolic mitral and tricuspid inflow velocities increased (1.3 ± 0.2 to 1.6 ± 0.5, p = 0.02; 1.0 ± 0.1 to 1.6 ± 0.3, p = 0.003). Early diastolic tissue Doppler velocities increased at both the lateral and septal mitral annulus (7.6 ± 1.5 to 9.3 ± 2.5 cm/s, p = 0.009; and 6.6 ± 1.4 to 7.7 ± 1.7 cm/s; p = 0.028, respectively) and for their 2-site average (7.2 ± 1.0 to 8.5 ± 1.7 cm/s, p = 0.007). Early diastolic tricuspid annular velocity increased (7.2 ± 2.8 to 10.6 ± 2.3 cm/s, p <0.001) as did the ratio of early-to-late tricuspid annular diastolic velocity (0.9 ± 0.4 to 1.1 ± 0.2, p = 0.038). Tricuspid annular systolic velocity increased (8.6 ± 2.5 to 10.3 ± 2.7 cm/s, p = 0.037). In patients with severe obesity, significant weight loss results in an increase in tricuspid annular systolic and early diastolic velocities and mitral annular early diastolic velocities.