Briston David A, Sabanayagam Aarthi, Zaidi Ali N
1Division of Pediatric Cardiology,Children's Hospital at Montefiore,Montefiore Medical Center,Bronx,New York,United States of America.
2Einstein Montefiore Center for Heart and Vascular Care,Montefiore Medical Center,Bronx,New York,United States of America.
Cardiol Young. 2017 Jul;27(5):890-894. doi: 10.1017/S1047951116001530. Epub 2016 Sep 22.
Obesity is increasingly prevalent, and abnormal body mass index is a risk factor for cardiovascular disease. There are limited data published regarding body mass index and CHD. We tested the hypothesis that body mass index and obesity prevalence are increasing in patients with tetralogy of Fallot over time by analysing time since surgery, age, height, weight, and body mass index among tetralogy of Fallot patients and demographic data from age-matched controls. NYHA class and left ventricular ejection fraction were analysed in adults. Body mass index was categorised into normal, overweight, and obese in this single-centre, retrospective chart review. Data were collected from 137 tetralogy of Fallot patients (71 men:66 women), of whom 40 had body mass index >25 kg/m2. Tetralogy of Fallot patients aged <6 years had lower body mass index (15.9 versus 17.1; p=0.042) until 16-20 years of age (27.4 versus 25.4; p=0.43). For adult tetralogy of Fallot patients, the mean body mass index was 26.5 but not statistically significantly different from the control cohort. Obese adult patients had significantly higher average NYHA class compared with those of normal weight (p=0.03), but no differences in left ventricular ejection fraction by echocardiography (p=0.55) or cardiac MRI (p=0.26) were noted. Lower body mass index was observed initially in tetralogy of Fallot patients, but by late adolescence no significant difference was observed. As adults, tetralogy of Fallot patients with higher body mass index had increased NYHA class but similar left ventricular ejection fraction.
肥胖日益普遍，而异常的体重指数是心血管疾病的一个危险因素。关于体重指数与冠心病的已发表数据有限。我们通过分析法洛四联症患者术后时间、年龄、身高、体重和体重指数以及年龄匹配对照组的人口统计学数据，检验了法洛四联症患者的体重指数和肥胖患病率随时间增加的假设。对成人患者分析了纽约心脏协会（NYHA）心功能分级和左心室射血分数。在这项单中心回顾性图表审查中，体重指数被分为正常、超重和肥胖。收集了137例法洛四联症患者（71例男性：66例女性）的数据，其中40例体重指数>25kg/m²。6岁以下的法洛四联症患者体重指数较低（15.9对17.1；p=0.042），直到16 - 20岁时（27.4对25.4；p=0.43）。对于成年法洛四联症患者，平均体重指数为26.5，但与对照组无统计学显著差异。肥胖成年患者的平均NYHA心功能分级显著高于体重正常者（p=0.03），但超声心动图（p=0.55）或心脏磁共振成像（p=0.26）显示左心室射血分数无差异。法洛四联症患者最初体重指数较低，但到青春期后期无显著差异。成年后，体重指数较高的法洛四联症患者NYHA心功能分级增加，但左心室射血分数相似。
