超声心动图评估肥胖对心脏结构和舒张功能的影响

目的:研究肥胖对心脏结构和左室舒张功能的影响以及比较左室舒张功能各项评价指标的敏感性。方法:选择100名健康体检者,根据体质指数分为正常体重组(对照组,25例),超重组(45例),肥胖组(30例)。应用常规超声心动图、组织多普勒成像技术和彩色M型多普勒对其进行检测,并对各组的心脏结构和左室舒张功能参数进行对比分析。结果:与对照组比较,超重组与肥胖组的左房、左室增大,室壁增厚,左室重量指数增加,二尖瓣瓣环舒张早期峰值运动速度(Ea)、Ea/二尖瓣瓣环舒张晚期峰值运动速度比值下降,二尖瓣舒张早期血流峰值速度(E)/Ea比值增加(P<0.05);肥胖组E值、E/二尖瓣舒张晚期血流峰值速度(A)比值下降,A值升高,等容舒张时间延长,舒张早期左室血流传播速度减慢(P<0.05)。与超重组比较,肥胖组心脏结构和舒张功能进一步恶化(P<0.05)。结论:肥胖可引起心脏肥大,左室舒张功能下降,且随体质指数的增加改变更明显。肥胖是亚临床左室舒张功能障碍的独立危险因素,在心肌迟缓型左室舒张功能下降阶段,综合多指标分析可提高左室舒张功能评价的准确性。组织多普勒和E/Ea较常规评价左室舒张功能的方法更敏感、有效。

Echocardiography evaluates effect of obesity on the cardiac structure and diastolic function

Objective:To investigate the effect of obesity on the cardiac structure and left ventricular(LV) diastolic function,and compare sensitivity of all the indexes in evaluating LV diastolic function.Method:One hundred health people undergoing medical examine were divided into normal weight group(control group,n=25),overweight group(n=45) and obese group(n=30) by body mass index(BMI).All subjects underwent routine echocardiography,tissue Doppler imaging(TDI) and color M-mode Doppler echocardiogram,and the parameters of heart structure and LV diastolic function of each group were comparatively analyzed.Result:Compared with control group,overweight group and obese group showed thickened ventricular walls,augmented left atrium and LV,increased LVMI and enhanced E/Ea,with Ea and Ea/Aa reduced(P<0.05);and E,E/A were lower,A was higher,IVRT was longer and FPV was faller in obese group than those in control group(P<0.05).The heart structure and diastolic function of obese group were worsened compared with those of overweight group(P<0.05).Conclusion:Obesity can lead to cardiac hypertrophy,decline of LV diastolic function,and the change is more obvious with the increase of BMI.Obesity is an independent risk factor of subclinical LV diastolic dysfunction.It is possible to improve the accuracy of the evaluation of LV diastolic function with multi-index comprehensive analyses in the declined phase of LV diastolic function belongs to myocardial retarda-tion-type.TDI and E/Ea is more sensitive and effective than conventional methods in evaluating LV diastolic function.