Iranian Heart Journal

Iranian Heart Journal

Bariatric Surgery Favorably Modulates Global Longitudinal Strain and Homeostatic Model Assessment for Insulin Resistance in Patients With Obesity Without Comorbidities

Document Type : Original Article

Authors
Shokoufeh Hajsadeghi 1
Aida Iranpour 2
Shiva Rahimipour Anaraki 3
Alireza Majd Pouya 3
Elahe Saberi Shahrbabaki 4
Ali Saberi Shahrbabaki 4
1 Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences (IUMS), Tehran, IR Iran.
2 Hematology and Oncology Department, Iran University of Medical Sciences, Tehran, IR Iran.
3 Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran.
4 Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Abstract
Background: The present study assessed the effect of bariatric surgery (BS) on left ventricular global longitudinal strain (LV-GLS) and homeostatic model assessment for insulin resistance (HOMA-IR) and investigated whether a correlation exists between LV-GLS and HOMA-IR in obese patients without comorbidities.

Methods: Patients with a body mass index (BMI) above 35 were included and underwent varying BS procedures. Patients’ data, comprising BMI calculation, HOMA-IR with fasting glucose and fasting insulin measurements, and evaluation of GLS with tissue Doppler echocardiography, were collected before BS and at 12-month follow-up after BS.

Results: A total of 142 patients who underwent BS were included in the study. BS significantly reduced HOMA-IR (mean difference, 3.79; P < .001), and mean GLS improved substantially postoperatively (mean difference, −3.25; P < .001). Among 18 patients with either borderline or abnormal GLS, all experienced improvement of GLS to the normal range in post-surgery follow-up (mean difference, −6.3; P < .01). Changes in GLS and HOMA-IR did not show a significant correlation with one another. Improvement in GLS and HOMA-IR scores did not differ significantly between BS subtypes (P = .78 and .83, respectively).

Conclusions: GLS could be measured before and after BS to determine LV function improvement in obese patients, given that obesity may have a direct hemodynamic effect on LV function independent of other consequences, such as hypertension and diabetes. Furthermore, regardless of the BS technique used, BS has a positive impact on HOMA-IR and GLS. (Iranian Heart Journal 2026; 27(4): 50-59)
Keywords
overweight
metabolic surgery
insulin sensitivity
LV-GLS
cardiac function tests
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Iranian Heart Journal
Volume 27, Issue 4
Autumn 2026
Pages 50-59