Cil Habib, Bulur Serkan, Türker Yasin, Kaya Ahmet, Alemdar Recai, Karabacak Ahmet, Aslantaş Yusuf, Ekinözü Ismail, Albayrak Sinan, Ozhan Hakan
Department of Cardiology, Medicine Faculty of Dicle University, Diyarbakır, Turkey.
Echocardiography. 2012 Jul;29(6):647-51. doi: 10.1111/j.1540-8175.2012.01688.x. Epub 2012 Apr 4.
The prevalence of obesity is increasing in the developed and developing world. It is an independent risk factor for heart failure. Left ventricular (LV) diastolic dysfunction has been demonstrated to be a strong predictor of heart failure. In the present study we aimed to assess the impact of body weight on LV diastolic function.
The study was conducted on 2,228 participants (1,424 women, 804 men with a mean age of 49). Traditional and tissue Doppler echocardiographic examination were performed in all of the participants. The demographic and echocardiographic data were compared. Multivariate logistic regression analysis was used to assess the independent predictors of association of LV diastolic function. The study sample was divided into four groups: group 1 (body mass index [BMI] < 25.0 kg/m(2) ), group 2 (BMI 25.0-29.9 kg/m(2)), group 3 (BMI ≥ 30-39.9 kg/m(2)), and group 4 (BMI ≥ 40 kg/m(2)).
Septal E was significantly lower in groups 2 and 3 compared to group 1 (P = 0.003). Septal A and septal A' were significantly higher whereas septal E' and lateral E' were significantly lower in the groups 2, 3, and 4 compared to the normal weight group (P < 0.001). Lateral A', deceleration time, and ejection time were significantly higher in obese when compared to the normal weight (P = 0.025, P < 0.001, and P = 0.009, respectively). The E/E' ratio was significantly higher in groups 2, 3, and 4 compared to the group 1 (P < 0.001). Logistic regression analysis revealed that age, BMI (OR = 1.060 [95% CI = 1.040 and 1.080]; P < 0.001), hypertension, and diabetes mellitus were independent predictors of LV diastolic dysfunction.
BMI is an independent predictor of LV diastolic dysfunction along with age, hypertension, and diabetes mellitus.
肥胖在发达国家和发展中国家的患病率都在上升。肥胖是心力衰竭的一个独立危险因素。左心室舒张功能障碍已被证明是心力衰竭的一个强有力的预测指标。在本研究中，我们旨在评估体重对左心室舒张功能的影响。
该研究对2228名参与者（1424名女性，804名男性，平均年龄49岁）进行。所有参与者均接受了传统及组织多普勒超声心动图检查。比较了人口统计学和超声心动图数据。采用多因素逻辑回归分析来评估左心室舒张功能相关的独立预测因素。研究样本分为四组：第1组（体重指数[BMI]<25.0kg/m²），第2组（BMI 25.0 - 29.9kg/m²），第3组（BMI≥30 - 39.9kg/m²），第4组（BMI≥40kg/m²）。
与第1组相比，第2组和第3组的室间隔E波明显更低（P = 0.003）。与正常体重组相比，第2、3、4组的室间隔A波和室间隔A'波明显更高，而室间隔E'波和侧壁E'波明显更低（P < 0.001）。与正常体重者相比，肥胖者的侧壁A'波、减速时间和射血时间明显更高（分别为P = 0.025、P < 0.001和P = 0.009）。与第1组相比，第2、3、4组的E/E'比值明显更高（P < 0.001）。逻辑回归分析显示，年龄、BMI（比值比[OR]=1.060[95%置信区间=1.040和1.080]；P < 0.001）、高血压和糖尿病是左心室舒张功能障碍的独立预测因素。
BMI与年龄、高血压和糖尿病一样，是左心室舒张功能障碍的独立预测因素。
