Cardiovascular Department, Cardiac Rehabilitation Operative Unit (SI), San Filippo Neri Hospital, Rome, Italy.
Hypertens Res. 2011 Apr;34(4):468-73. doi: 10.1038/hr.2010.266. Epub 2011 Jan 13.
Very few data exist regarding the effect of obesity on both left and right systo-diastolic ventricular function in hypertensive patients. Therefore, the aim of this study was to determine the existence and extent of an obesity-related adjunctive depressive effect on left- and right-ventricular systo-diastolic dysfunction. This study compared non-obese with obese hypertensive patients and evaluated left- and right-ventricular morphological and functional parameters by means of conventional echocardiography and by two new sensitive echocardiographic techniques: tissue Doppler velocity and strain imaging. We selected 248 hypertensive patients and divided them into four groups according to increasing body mass index (BMI). All patients underwent a clinical history and examination and transthoracic echocardiography, including conventional echocardiographic evaluation and tissue Doppler velocity and strain imaging measurements. Conventional echocardiographic evaluation did not reveal an association between ventricular systo-diastolic dysfunction and increasing BMI. In contrast, tissue Doppler velocity and strain imaging measurements emphasized the negative influence of obesity. For measurements in both the left and right ventricle, myocardial early peak diastolic velocities (E(m)), the ratio of myocardial early-to-late peak diastolic velocity (E(m)/A(m)), myocardial peak systolic velocities (S(m)), and peak strain and strain rate values significantly decreased with increasing BMI (P<0.01 for all parameters measured), even after adjusting for potential confounding variables. In conclusion, by means of new more sensitive echocardiographic techniques, our study clearly demonstrated the negative impact of obesity on both left- and right-ventricular systo-diastolic function, in terms of adjunctive sub-clinical worsening, in hypertensive patients.
关于肥胖对高血压患者左、右心室收缩和舒张功能的影响，相关数据非常有限。因此，本研究旨在确定肥胖对左、右心室收缩和舒张功能是否存在附加的抑郁影响及其程度。本研究比较了非肥胖和肥胖的高血压患者，并通过常规超声心动图和两种新的敏感超声心动图技术（组织多普勒速度和应变成像）评估了左、右心室的形态和功能参数。我们选择了 248 名高血压患者，并根据体重指数（BMI）的增加将他们分为四组。所有患者均接受了病史和体格检查以及经胸超声心动图检查，包括常规超声心动图评估和组织多普勒速度和应变成像测量。常规超声心动图评估未显示心室收缩和舒张功能与 BMI 增加之间存在关联。相比之下，组织多普勒速度和应变成像测量强调了肥胖的负面影响。对于左、右心室的所有测量值，心肌早期舒张峰值速度（E(m)）、心肌早期至晚期舒张峰值速度比（E(m)/A(m)）、心肌收缩峰值速度（S(m)）以及峰值应变和应变率值均随着 BMI 的增加而显著降低（所有参数测量值 P<0.01），即使在调整了潜在的混杂变量后也是如此。总之，通过新的更敏感的超声心动图技术，本研究清楚地表明了肥胖对高血压患者左、右心室收缩和舒张功能的负面影响，即附加的亚临床恶化。
