青年肥胖患者左心室应变与心外膜脂肪厚度的关系  

Association between left ventricular strain and thickness of epicardial adipose tissue in young obese patients

作　　者：刘敏娜 陈文苏 李菲 胡晓芹 李承宗 张超群 朱孝成 王志荣 Liu Minna;Chen Wensu;Li Fei;Hu Xiaoqin;Li Chengzong;Zhang Chaoqun;Zhu Xiaocheng;Wang Zhirong(Department of Cardiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属医院心内科,221000

出　　处：《中国心血管杂志》2023年第2期130-135,共6页Chinese Journal of Cardiovascular Medicine

摘　　要：目的探讨青年肥胖患者心外膜脂肪(EAT)与左心室功能的关系。方法连续纳入2021年3月至2022年3月在徐州医科大学附属医院行减重手术、左心室收缩功能正常的121例青年肥胖患者,收集术前血液学检查资料,采用超声心动图测量EAT,EAT厚度为收缩末期右心室游离壁与心包脏层之间的无回声空间。通过二维斑点追踪成像技术(2D-STE)测量左心室整体纵向应变(GLS),利用HFA-PEFF评分表评估舒张功能。根据GLS分为两组:GLS≥18%(48例)和GLS<18%(73例),多因素线性回归分析GLS降低的影响因素。结果与GLS≥18%组比较,GLS<18%组患者的腰臀比、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、糖化血红蛋白、高敏C反应蛋白、E/e’、左心房容积、左心房容积指数、EAT厚度和HFA-PEFF评分均较高(均为P<0.05)。多因素线性回归分析显示,EAT厚度、低密度脂蛋白胆固醇、糖化血红蛋白和高敏C反应蛋白均与左心室GLS独立相关(均为P<0.05)。结论在青年肥胖群体中,EAT增厚与左心室功能的不良改变有一定程度的相关性。Objective To investigate the association between epicardial adipose tissue(EAT)and left ventricular function in young obese patients.Methods A total of 121 young obese patients undergoing bariatric surgery with normal left ventricular(LV)systolic function were consecutively enrolled in Affiliated Hospital of Xuzhou Medical University,and preoperative laboratory data was collected.The thickness of EAT was measured using echocardiography.The EAT thickness was defined as the space between the free wall of the right ventricle and the visceral layer of pericardium at end-systole.LV systolic function was evaluated by global longitudinal strain(GLS)measured by two dimensional speckle tracking echocardiography(2D-STE).The HFA-PEFF Score Scale was used for evaluation of diastolic function.Patients were divided into two groups according to the GLS of LV:GLS≥18%(48 cases)and GLS<18%(73 cases).Multivariate linear regression analysis was used to evaluate the influencing factors of GLS reduction.Results Compared with GLS≥18%group,patients in the GLS<18%group were associated with increased levels of waist-hip ratio,total cholesterol,triglyceride,low-density lipoprotein cholesterol,glycated hemoglobin,high sensitivity C-reactive protein(hs-CRP),E/e’,left atrial volume,left atrial volume index,EAT thickness and HFA-PEFF Score(all P<0.05).Multivariate linear regression analysis revealed that EAT thickness,low-density lipoprotein cholesterol,glycated hemoglobin,and s CRP were independently associated with LV GLS(all P<0.05).Conclusions There is a certain degree of correlation between increased EAT thickness and adverse changes in LV function among young obese patients.

关 键 词：青年 肥胖 心外膜脂肪 左心室功能 

分 类 号：R589.2[医药卫生—内分泌]