左室压力-应变环评估肥胖合并高血压患者心肌做功的价值  

Evaluation of left ventricular myocardial work in obese patients with hypertension by left ventricular pressure-strain loop

作　　者：张彦平 张佳宇 张燕霞[2] 康春松[2] ZHANG Yanping;ZHANG Jiayu;ZHANG Yanxia;KANG Chunsong(School of Medical Imaging,Shanxi Medical University,Taiyuan 030001,China;Department of Ultrasound,Third Hospital of Shanxi Medical University/Shanxi Bethune Hospital,Taiyuan 030032,China)

机构地区：[1]山西医科大学医学影像学院,山西太原030001 [2]山西医科大学第三医院/山西白求恩医院超声科,山西太原030032

出　　处：《分子影像学杂志》2024年第2期183-188,共6页Journal of Molecular Imaging

摘　　要：目的 探讨左室压力-应变环评价肥胖合并高血压患者心肌做功的临床价值。方法 选取2020年5月~2022年8月就诊于山西白求恩医院的35例单纯性肥胖患者(肥胖组)、39例肥胖合并高血压患者(肥胖高血压组)及38例健康人(对照组),测量常规超声心动图参数、整体纵向应变(GLS)及心肌做功参数,心肌做功参数包括整体有用功(GCW)、整体做功指数(GWI)、整体无用功(GWW)、整体做功效率(GWE),比较3组间上述参数的差异。结果 肥胖组和肥胖高血压组的GLS低于对照组(P<0.05)。与对照组相比,肥胖组GLS、GCW、GWI、GWE减小,GWW增大(P<0.05)。肥胖高血压组较肥胖组、对照组GCW、GWI、GWW增大,GWE减小(P<0.05)。收缩压、舒张压与GCW、GWI、GWW呈正相关、与GLS呈负相关(P<0.01)。BMI与GCW、GWI、GLS呈负相关,与GWW呈正相关(P<0.05)。结论 高血压会加重肥胖患者左心功能功能障碍,左室压力-应变环能够识别肥胖合并高血压左室心肌功能受损,具有一定临床价值。Objective To explore the clinical value of left ventricular pressure strain loop in evaluating myocardial work in obese patients with hypertension.Methods Thirty-five patients with simple obesity(obese group),39 patients with obesity combined with hypertension(obese hypertension group)and 38 healthy subjects(control group)were selected from Shanxi Bethune Hospital from May 2020 to August 2022.Conventional echocardiographic parameters,global longitudinal strain(GLS)and myocardial work parameters were measured.The myocardial work parameters included global constructive work(GCW),global work index(GWI),global wasted work(GWW)and global work efficiency(GWE),and the differences of these parameters among the three groups were compared.Results The GLS of the obese group and the obese hypertensive group was lower than that of the control group(P<0.05).Compared with the control group,the GCW,GWI and GWE of the obesity group decreased,and GWW increased(P<0.05).Compared with the obesity group and the control group,the GCW,GWI and GWW of the obesity and hypertension group increased,and GWE decreased(P<0.05).Systolic blood pressure and diastolic blood pressure were positively correlated with GCW,GWI and GWW,and negatively correlated with GLS(P<0.01).BMI was negatively correlated with GCW,GWI and GLS,and positively correlated with GWW(P<0.05).Conclusion Hypertension can aggravate left ventricular dysfunction in obese patients.Left ventricular pressure-strain loop can identify left ventricular myocardial dysfunction in obesity patients with hypertension,which has certain clinical value.

关 键 词：肥胖 高血压 超声心动图 左室压力-应变环 心肌做功 

分 类 号：R589.2[医药卫生—内分泌] R544.1[医药卫生—内科学] R540.45[医药卫生—临床医学]