组织多普勒成像技术评价健康肥胖老年女性心功能

目的探讨组织多普勒成像(TDI)技术能否早期、准确评价健康肥胖老年女性左心功能的改变。方法入选健康老年女性160例,其中肥胖女性120例,根据体重指数(BMI)分为:轻度肥胖组(Ⅰ组,70例),28.0 kg/m~2≤BMI32.0 kg/m~2;中度肥胖组(Ⅱ组,50例),32.0 kg/m~2≤BMI36.0 kg/m~2;正常体重组(Ⅲ组,40例),18.5kg/m~2≤BMI24.0 kg/m~2。同期选择健康肥胖非老年女性80例,以BMI为依据,分为Ⅳ组40例(BMI同Ⅰ组),V组40例(BMI同Ⅱ组)。超声心动图检查,以TDI技术测量二尖瓣瓣环后间壁、侧壁、下壁、前壁、后壁和前间壁6个取样点的收缩期心肌峰值运动速度(Sm)、舒张早期心肌峰值运动速度(Em)和舒张晚期心肌峰值运动速度(Am)及其比值,并进行对比分析。结果与Ⅲ组比较,Ⅰ、Ⅱ组入选者收缩压、舒张压增高,心率加快,二尖瓣口舒张早期与晚期峰值血流速度比值明显降低(P0.05);Ⅰ、Ⅱ组在二尖瓣环6个取样点Sm、Em、Em/Am和总平均值均明显下降,Am明显上升,差异有统计学意义(P0.05)。与Ⅳ组比较,Ⅰ组在6个取样点Sm、Em、Em/Am和总平均值明显下降,差异有统计学意义(P0.05),与Ⅰ组比较,Ⅱ组亦有相似改变。与Ⅴ组比较,Ⅱ组仅Sm减低,差异有统计学意义(P0.05)。结论心肌组织运动速度测量显示,健康肥胖老年女性已出现心室收缩和舒张功能异常,心肌TDI技术的应用,为这类人群左心室局部和整体功能的评价提供了理想的检测手段。

Evaluation of left ventricular function in healthy obese old women by tissue Doppler imaging

Objective To investigate assessing left ventricular function in healthy obese old women by tissue Doppler imaging (TDI).Methods 160 healthy old women were divided into mild and moderate obese and normal weight groups(groups Ⅰ ,Ⅱ and Ⅲ respectively).Eighty healthy mild and moderate obese and not old women(groups Ⅳ and Ⅴ respectiely) were choosed as controls. All of them underwent DTI.Peak systolic and peak early and late diastolic velocities(Sm,Em, Am) and Em/Am were measured at six sample sites of mitral annulus,and mean value of every index was calculated.Results Compared with group Ⅲ,group Ⅰ and Ⅱ had higher systolic and diastolic blood pressure and faster heart rate and lower Em/Am (P< 0.05).There were significant differences of Sm,Em,Am and Em/Am at six sample sites of mitral annulus,and the mean value of every index between groups Ⅰ and Ⅱ and groupⅢ ,and differences of Sm,Em and Em/Am between group Ⅰ and group Ⅳ ,and between group Ⅰ and group Ⅱ.Only Sm in group Ⅱ was lower than that in groupⅤ (P < 0.05).Conclusions By measuring myocardial tissue movement velocities using TDI,it was showed that left ventricular function has become abnormal in healthy obese old women.Due to more sensitive than conventional echocardiography,TDI provides an ideal method for evaluating left ventricular function early in healthy obese old women.