二维斑点追踪成像评价代谢综合征患者右心室收缩功能及与心外膜脂肪厚度关系的研究

目的：应用二维斑点追踪成像（2D-STI）评价代谢综合征（MS）患者右心室收缩功能改变并探讨其与心外膜脂肪厚度之间的关系。方法：本研究选取100名参与者（MS患者65名,对照组35名）进行常规超声心动图及二维斑点追踪检查,比较上述两组间临床及超声指标的差异。采用Pearson、Spearman相关系数分析FWS与各代谢因素之间的相关性;采用多元线性回归分析FWS的独立影响因素;采用Bootstrap方法分析部分临床指标是否介导EAT与FWS之间的关联。结果：MS组RVGLS、RVFWS低于对照组(P<0.05);MS组FWS与EAT、年龄、收缩压、舒张压、BMI、腰高比、GLU、TG、LDL-C、TC呈负相关,与HDL-C呈正相关（P<0.05）;EAT、收缩压、GLU、TG、HDL-C是FWS的独立影响因素（P<0.05）;EAT对FWS有直接影响,且收缩压、GLU、TG、HDL-C部分介导EAT对FWS的影响。结论：2D-STI较常规超声心动图能更敏感、准确地发现MS患者早期右心室收缩功能障碍。MS患者中,EAT是FWS的独立影响因素;EAT通过循环代谢部分介导其对右心室的毒性作用。

Study on the relationship between right ventricular systolic function and epicardial fat thickness in patients with metabolic syndrome evaluated by two-dimensional spot tracking imaging

Abstract:Objective Two-dimensional spot tracking imaging (2D-STI) was used to evaluate the changes in right ventricular systolic function in patients with metabolic syndrome (MS) and to explore the relationship between the changes and epicardial fat thickness.Method In this study,100 participants (65 in MS patients and 35 in the control group) underwent routine echocardiography and two-dimensional spot tracking to compare the differences in clinical and ultrasonic indicators between the two groups.Pearson and Spearman correlation coefficients were used to analyze the correlation between FWS and metabolic factors.Multiple linear regression was used to analyze the independent influencing factors of FWS.Bootstrap method was used to analyze whether some clinical indicators mediated the association between EAT and FWS.Result RVGLS and RVFWS in MS group were lower than those in control group(P<0.05);FWS in case group was negatively correlated with EAT,age,systolic blood pressure,diastolic blood pressure,BMI,waist-height ratio,GLU,TG,LDL-C and TC,and positively correlated with HDL-C (P<0.05);EAT,systolic blood pressure,GLU,TG and HDL-C were independent influencing factors of FWS (P<0.05);EAT has a direct effect on FWS,and systolic blood pressure,GLU,TG,HDL-C partially mediate the effect of EAT on FWS.Conclusion Compared with conventional echocardiography,2D-STI can detect early right ventricular systolic dysfunction more sensitively and accurately in MS patients.In MS patients,EAT was an independent influencing factor of FWS;EAT partially mediates its toxic effects on the right ventricle through circulatory metabolism.