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代谢综合征患者的亚临床左心室收缩功能障碍:一项使用二维斑点追踪超声心动图的病例对照研究。

Subclinical left ventricular systolic dysfunction in patients with metabolic syndrome: A case-control study using two-dimensional speckle tracking echocardiography.

作者信息

Moaref Alireza, Faraji Majid, Tahamtan Maryam

机构信息

Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

ARYA Atheroscler. 2016 Nov;12(6):254-258.

Abstract

BACKGROUND

The dramatic increase in the prevalence of metabolic syndrome is associated with more increased cardiovascular morbidity and mortality in this group. Some recent studies suggested that metabolic syndrome is associated with increased risk of subclinical left ventricular (LV) systolic dysfunction. In the present cross-sectional case-control study, the utility of two-dimensional speckle tracking echocardiography (STE) was examined to detect early LV systolic dysfunction in this population.

METHODS

A total of 75 clinically asymptomatic subjects with left ventricular ejection fraction (LVEF) ≥ 55%, 39 without metabolic syndrome and 36 with metabolic syndrome, matched for gender and age, were enrolled in this case-control study. Metabolic syndrome was diagnosed using the National Cholesterol Education Program/Adult Treatment Panel III criteria. LV systolic function was assessed by STE-derived global and segmental longitudinal strain (εLL).

RESULTS

Global εLL was significantly lower in patients with metabolic syndrome compared with normal population (-18.41 ± 2.20% vs. -21.2 ± 2.1%, P < 0.001). Segmental εLL was significantly lower in patients with metabolic syndrome in comparison to control group except for basal anteroseptal (-19.95 ± 2.90% vs. -21.15 ± 3.30%, P = 0.106), basal anterolateral (-17.5 ± 5.0% vs. -18.3 ± 4.1%, P = 0.437), and basal inferolateral segments (-18.1 ± 6.3% vs. -18.9 ± 4.1%, P = 0.526).

CONCLUSION

STE-derived longitudinal LV strain (εLL), a marker of subclinical cardiovascular disease, is impaired in asymptomatic individuals with metabolic syndrome and normal LVEF.

摘要

背景

代谢综合征患病率的急剧上升与该群体中心血管疾病发病率和死亡率的进一步增加相关。最近的一些研究表明,代谢综合征与亚临床左心室(LV)收缩功能障碍风险增加有关。在本横断面病例对照研究中,检测了二维斑点追踪超声心动图(STE)在该人群中检测早期LV收缩功能障碍的效用。

方法

本病例对照研究共纳入75例临床无症状、左心室射血分数(LVEF)≥55%的受试者,其中39例无代谢综合征,36例有代谢综合征,按性别和年龄匹配。采用美国国家胆固醇教育计划/成人治疗小组第三次报告标准诊断代谢综合征。通过STE得出的整体和节段纵向应变(εLL)评估LV收缩功能。

结果

与正常人群相比,代谢综合征患者的整体εLL显著降低(-18.41±2.20%对-21.2±2.1%,P<0.001)。除基底前间隔(-19.95±2.90%对-21.15±3.30%,P=0.106)、基底前外侧(-17.5±5.0%对-18.3±4.1%,P=0.437)和基底下外侧节段(-18.1±6.3%对-18.9±4.1%,P=0.526)外,代谢综合征患者的节段εLL与对照组相比显著降低。

结论

STE得出的LV纵向应变(εLL)是亚临床心血管疾病的一个标志物,在LVEF正常的无症状代谢综合征个体中受损。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00d3/5455323/01b794ffe6d6/ARYA-12-254f1.jpg

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