| 摘要: |
| 目的 应用无创左心室压力-应变环（pressure - strain loops，PSL）技术评价超重及肥胖患者左心室心肌做功参数的变化，探讨应用心肌做功参数评估肥胖症患者左心室心肌功能受损的临床价值。方法 收集我院减重代谢外科门诊及住院肥胖症患者64例作为观察组，根据BMI将肥胖症患者分为超重组（24kg/m2≤BMI＜28kg/m2）和 肥胖组（BMI ≥ 28kg/m2），每组32例，健康志愿者46例作为对照组。各组均行超声心动图检查，应用斑点追踪技术获得整体纵向应变 （Global longitudinal strain，GLS），应用 PSL 技术获得心肌做功参数，包括整体做功指数 （Global work index，GWI）、 整体有用功 （Global constructive work，GCW）、 整体无用功（Global waste work，GWW）及整体做功效率（Global work efficiency，GWE）。比较三组间常规超声心动图及心肌做功参数的差异，分析心肌做功参数与GLS、BMI的相关性。结果 ①常规超声心动图参数：3组间常规超声心动图参数比较，差异均无统计学意义（P均＞0.05）。 ②应变参数和心肌做功参数：与对照组比较，超重组、肥胖组 GLS、GWI、GCW 均减低（P均＜0.05），而GWW增加（P＜0.05）。 肥胖组 GLS、GWI、GCW 较超重组减低、GWW增加更为显著（P均 ＜0.05）。 ③相关性分析：GLS与 GWI、GCW 呈正相关（r＝0.875，0.833，P均＜0.001），与 GWW呈负相关（r ＝-0.879，P＜0.001），与GWE无相关性（P＞0.05）；GLS、GWI、GCW 与 BMI呈 负 相 关（r ＝-0.861，-0.744，-0.763，P均＜0.05 ），GWW与BMI呈正相关（r ＝0.897，P＜0.05），且GLS与BMI相关性最高。结论 超重及肥胖患者均出现心肌做功明显减低，PSL技术可早期反应肥胖症患者左心室收缩功能损伤，且BMI越高，左心室收缩功能受损越严重 。 |
| 关键词: 压力 - 应变环 肥胖症 心肌做功 |
| DOI： |
| 投稿时间：2023-02-08修订日期：2023-02-15 |
| 基金项目: |
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| Assessment of left ventricular systolic function in simple obesity by pressure-strain loop |
| cuirongrong,xuejiping |
| (Department of Ultrasound，Shanxi Bethune Hospital，Shanxi Medical University) |
| Abstract: |
| Objective To evaluate the changes of left ventricular myocardial work in overweight and obese patients by using non-invasive left ventricular pressure strain loops (PSL) technology, and to explore the clinical value of myocardial work in the assessment of left ventricular myocardial function impariment in obese patients. Methods A total of 64 obese patients were collected from the outpatients and inpatients of Bariatric Metabolic Surgery in our hospital as the observation group. According to BMI, the obese patients were divided into overweight group (24kg/m2≤BMI <28kg/m2) and obese group (BMI ≥ 28kg/m2), with 32 cases in each group and 46 healthy volunteers were collected as the control group. Echocardiography was performed in all groups. the Global longitudinal strain (GLS) were obtained by speckle tracking technique, and the myocardial work parameters were obtained by PSL technique, including the global work index(GWI), global constructive work (GCW), global waste work(GWW) and global work efficiency(GWE). Left ventricular routine echocardiography and myocardial work parameters among the three groups were compared, and the correlation between myocardial work parameters with GLS and BMI was analyzed. Result ① Routine echocardiographic parameters: There were no significant differences in routine echocardiographic parameters among the three groups (all P>0.05). ②Strain parameters and myocardial work parameters: compared with the control group, GLS, GWI and GCW were decreased in overweight groups and obese groups (P<0.05), while GWW was increased (P<0.05). GLS, GWI and GCW decreased and GWW increased significantly in obese groups compared with overweight groups(P<0.05). ③ Correlation analysis: GLS was positively correlated with GWI and GCW (r=0.875, 0.833, P<0.001), but negatively correlated with GWW (r = -0.879, P<0.001), and had no correlated with GWE (P>0.05). GLS, GWI and GCW were negatively correlated with BMI (r = -0.861, -0.744, -0.763, all P<0.05), GWW was positively correlated with BMI (r = 0.897, P<0.05), and GLS had the highest correlation with BMI. Conclusion The myocardial function of overweight and obese patients was significantly reduced . PSL technology can early reflect the damage of left ventricular systolic function in obese patients, and the higher the BMI, the more serious the damage of left ventricular systolic function. |
| Key words: Pressure - strain loops,Obesity,Myocardial work |
