肥胖患者接受减重手术后发生的心肌力学变化。

Changes in myocardial mechanics in patients with obesity following major weight loss after bariatric surgery.

机构信息

Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

出版信息

Obesity (Silver Spring). 2013 Jun;21(6):1111-8. doi: 10.1002/oby.20168.

DOI:10.1002/oby.20168

PMID:23913728

Abstract

OBJECTIVE

The purpose of this study was to evaluate myocardial mechanics in obese subjects using 2D-speckle tracking echocardiography (2D-STE).

DESIGN AND METHODS

63 obese individuals, including 28 who underwent bariatric surgery for weight loss (BMI 51 ± 9 kg/m2) and 35 managed conservatively (BMI 43 ± 7 kg/m2 ) were included. Changes in strain (S) and strain rate (SR) measured by 2D-STE. Mean follow-up was 23 ± 10 months.

RESULTS

The surgery group had a significant weight loss (BMI 37 ± 10 kg/m2 , P < 0.0001), but no change was noted in the nonsurgery group (BMI 42 ± 7 kg/m2 , P = 0.1). For the surgery group, S and SR in early diastole (SRe) improved significantly in the longitudinal left ventricle (LV) (S: P = 0.0004, SRe: P = 0.02) and right ventricle (RV) (S: P = 0.02, SRe: P = 0.009), whereas no changes were seen in LV ejection fraction (LVEF). In the nonsurgery group, there was no change in S, SR, or body weight. For all patients, weight changes correlated significantly with changes in LV S (r = 0.43, P = 0.0005).

CONCLUSIONS

The improvement of S after bariatric surgery suggests that weight loss could improve myocardial performance, despite the lack of change in LVEF.

摘要

目的

本研究旨在通过二维斑点追踪超声心动图（2D-STE）评估肥胖患者的心肌力学。

设计和方法

共纳入 63 例肥胖患者，其中 28 例行减重手术（BMI 51±9kg/m2），35 例保守治疗（BMI 43±7kg/m2）。通过 2D-STE 测量应变（S）和应变率（SR）的变化。平均随访时间为 23±10 个月。

结果

手术组体重明显减轻（BMI 37±10kg/m2，P<0.0001），但非手术组体重无变化（BMI 42±7kg/m2，P=0.1）。对于手术组，左心室（LV）和右心室（RV）的早期舒张期 S 和 SR（SRe）明显改善（S：P=0.0004，SRe：P=0.02），而 LV 射血分数（LVEF）无变化。非手术组中，S、SR 或体重均无变化。对于所有患者，体重变化与 LV S 的变化显著相关（r=0.43，P=0.0005）。