Bariatric Surgery in Patients with Heart Failure: A Literature Review

Abstract

Background: The confluence of obesity and heart failure is an expanding epidemic across the globe. As global rates of all forms of adiposity rise, so does the prevalence of obesity-mediated heart failure. Conventional medical management of heart failure is often unsatisfactory in obese patients owing to complex pathophysiological interactions between excess adiposity and cardiac performance.
Objective: To systematically appraise the existing evidence related to outcomes of bariatric surgery in patients with heart failure and severe obesity based on safety profiles, effectiveness, weaknesses, mechanistic insights, and clinical relevance.
Methods: We performed a comprehensive literature search and screened articles published between 2014 and 2024 on outcomes of bariatric surgery in patients with heart failure. Major databases such as PubMed, EMBASE, and Cochrane Library were searched using appropriate keywords.
Results: Current evidence shows that bariatric surgery substantially enhances cardiac functioning, reduces hospitalizations, and increases survival in carefully selected patients with heart failure and severe obesity. Left ventricular ejection fraction improved between 22 percent to 35 percent after the procedure. A decrease of nearly 80 percent in readmission rates following discharge, coupled with a reduction of 50 percent in all-cause mortality versus conservative treatment.
Conclusion: Bariatric surgery may be a favorable therapeutic strategy in those patients presenting severely symptomatic heart failure with severe obesity, but careful patient selection criteria and a multimodal approach are key to achieving the best outcomes.