Cardiac remodeling after bariatric surgery associates with systemic metabolic reprogramming: a longitudinal untargeted metabolomics study
Authors' conclusion
Early geometric cardiac adaptation following bariatric surgery-primarily reflected by reductions in relative wall thickness (RWT), with modest and non-significant changes in LVMI at the cohort level-is associated with coordinated changes in systemic metabolic profiles. These findings suggest potential metabolic correlates of early cardiac adaptation while highlighting substantial interindividual variability. Metabolomic profiling provides insights into individual metabolic trajectories and may inform future strategies for cardiometabolic risk stratification.
Study context
- Population
- Adults with severe obesity undergoing bariatric surgery, evaluated at baseline and 4, 12 and 24 weeks post-surgery
- Participants
- 127 adults
- Outcome
- Longitudinal changes in serum metabolome and their relationship with regression of concentric cardiac remodeling
- Follow-up
- Baseline, 4, 12 and 24 weeks post-surgery
Methodological detailslongitudinal, untargeted GC-MS-based metabolomics
- Longitudinal
- Untargeted GC-MS-based metabolomics
Main finding
As reported in the abstract
- Changes in cardiac geometry mainly within first 12 weeks, driven by reductions in relative wall thickness (RWT)
- Left ventricular mass index (LVMI) showed only modest, non-significant changes at cohort level
- Time-dependent metabolomic shifts in amino acid, fatty acid and ketone metabolism
- Early favorable cardiac remodeling associated with enriched signatures of mitochondrial substrate flexibility (short-chain fatty acids, branched-chain amino acid metabolites, dicarboxylic acids)
- LASSO regression identified specific metabolite sets associated with reductions in LVMI and RWT
Observational data: associations, not effects.
Original publication
Cardiac remodeling after bariatric surgery associates with systemic metabolic reprogramming: a longitudinal untargeted metabolomics study. Cardiovasc Diabetol. Published 2 June 2026. doi:10.
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