TY - JOUR
T1 - Impact of metabolic and bariatric surgery on heart rate variability
T2 - a systematic review and meta-analysis
AU - Jamialahmadi, Tannaz
AU - Abdalla, Mohammed Altigani
AU - Mirhadi, Elaheh
AU - Almahmeed, Wael
AU - Sukhorukov, Vasily N.
AU - Virani, Salim
AU - Eid, Ali H.
AU - Sahebkar, Amirhossein
N1 - Publisher Copyright:
© Italian Society of Surgery (SIC) 2025.
PY - 2025
Y1 - 2025
N2 - Obesity is associated with autonomic nervous system (ANS) dysfunction, characterized by increased sympathetic activity, and reduced parasympathetic tone, which together contribute to elevated cardiovascular risk. Heart rate variability (HRV), a key marker of ANS function, is often reduced in individuals with obesity. Metabolic and bariatric surgery (MBS) is an effective intervention for severe obesity; however, its impact on HRV remains unclear. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Literature searches were performed in PubMed, Scopus, Embase, Google Scholar, and Web of Science. Studies evaluating HRV before and after MBS were included. Meta-analysis was carried out using Comprehensive Meta-Analysis (CMA) version 4 software. Eleven studies comprising 322 patients were included. MBS significantly improved HRV (weighted mean difference: 12.011; 95% CI: 6.984–17.038; p < 0.001). Meta-regression demonstrated a positive correlation between BMI reduction and HRV improvement (slope: 1.553; 95% CI: 0.203–2.903; p = 0.024). HRV improvements were observed at both short-term (< 6 months) and long-term (≥ 6 months) follow-up. Roux-en-Y gastric bypass (RYGB) produced greater HRV improvements compared with sleeve gastrectomy (SG). MBS significantly enhances HRV, suggesting partial reversal of obesity-related ANS dysfunction. The observed association between weight loss and HRV improvement highlights MBS as a promising cardiometabolic intervention.
AB - Obesity is associated with autonomic nervous system (ANS) dysfunction, characterized by increased sympathetic activity, and reduced parasympathetic tone, which together contribute to elevated cardiovascular risk. Heart rate variability (HRV), a key marker of ANS function, is often reduced in individuals with obesity. Metabolic and bariatric surgery (MBS) is an effective intervention for severe obesity; however, its impact on HRV remains unclear. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Literature searches were performed in PubMed, Scopus, Embase, Google Scholar, and Web of Science. Studies evaluating HRV before and after MBS were included. Meta-analysis was carried out using Comprehensive Meta-Analysis (CMA) version 4 software. Eleven studies comprising 322 patients were included. MBS significantly improved HRV (weighted mean difference: 12.011; 95% CI: 6.984–17.038; p < 0.001). Meta-regression demonstrated a positive correlation between BMI reduction and HRV improvement (slope: 1.553; 95% CI: 0.203–2.903; p = 0.024). HRV improvements were observed at both short-term (< 6 months) and long-term (≥ 6 months) follow-up. Roux-en-Y gastric bypass (RYGB) produced greater HRV improvements compared with sleeve gastrectomy (SG). MBS significantly enhances HRV, suggesting partial reversal of obesity-related ANS dysfunction. The observed association between weight loss and HRV improvement highlights MBS as a promising cardiometabolic intervention.
KW - Autonomic nervous system
KW - Cardiovascular health
KW - Heart rate variability
KW - Meta-analysis
KW - Metabolic and Bariatric surgery
KW - Obesity
UR - https://www.scopus.com/pages/publications/105018782626
U2 - 10.1007/s13304-025-02444-2
DO - 10.1007/s13304-025-02444-2
M3 - Article
AN - SCOPUS:105018782626
SN - 2038-131X
JO - Updates in Surgery
JF - Updates in Surgery
ER -
