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肥胖对无近期心肌梗死的慢性缺血性心脏病并保留左心室射血分数患者左房时相功能的影响:二维斑点追踪超声心动图研究。

Effects of obesity on left atrial phasic functions in patients with chronic ischemic heart disease and preserved left ventricular ejection fraction without recent myocardial infarction: a two-dimensional speckle-tracking echocardiography study.

机构信息

Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Karegar Shomali Street, Tehran, I.R. of Iran.

出版信息

J Ultrasound. 2022 Sep;25(3):521-527. doi: 10.1007/s40477-021-00616-5. Epub 2021 Dec 2.

Abstract

PURPOSE

Left atrial (LA) phasic functions in various subgroups of subjects with obesity are differently impaired, suggesting that obesity may have diverse effects in dissimilar subgroups of subjects with obesity. We aimed to compare the effects of obesity on LA phasic functions in patients suffering from chronic ischemic heart disease with a preserved left ventricular ejection fraction and without a recent myocardial infarction.

METHODS

In our cross-sectional study, 145 consecutive candidates for isolated coronary artery bypass graft (CABG) surgery were divided according to the presence of obesity into 2 groups: obese (36 patients) and nonobese (103 patients), and LA phasic functions were evaluated by two-dimensional speckle-tracking echocardiography (2D STE).

RESULTS

The longitudinal strain rate during the reservoir phase (3.0 ± 0.7 s vs 2.7 ± 0.6 s; P = 0.032), longitudinal strain during the contraction phase (19.2 ± 4.7% vs 17.2 ± 4.1%; P = 0.022), and the longitudinal strain rate during the contraction phase (4.4 ± 1.2 s vs 3.9 ± 1.2 s; P = 0.036) decreased in the obese group compared with the nonobese group. The other longitudinal 2D STE-derived markers of the LA phasic functions were not different between the 2 groups.

CONCLUSIONS

Among patients suffering from chronic ischemic heart disease with a preserved left ventricular ejection fraction and without a recent myocardial infarction, LA reservoir and contraction functions as measured by 2D STE were impaired in patients with obesity compared with those without it.

摘要

目的

左心房(LA)的时相功能在肥胖的不同亚组中存在不同程度的损害,这表明肥胖可能对肥胖的不同亚组有不同的影响。我们旨在比较肥胖对射血分数保留且近期无心肌梗死的慢性缺血性心脏病患者左心房时相功能的影响。

方法

在我们的横断面研究中,根据是否存在肥胖,将 145 名连续的孤立冠状动脉旁路移植术(CABG)候选者分为两组:肥胖组(36 例)和非肥胖组(103 例),并通过二维斑点追踪超声心动图(2D STE)评估 LA 时相功能。

结果

储液期的纵向应变率(3.0±0.7 s 比 2.7±0.6 s;P=0.032)、收缩期的纵向应变(19.2±4.7% 比 17.2±4.1%;P=0.022)和收缩期的纵向应变率(4.4±1.2 s 比 3.9±1.2 s;P=0.036)在肥胖组中均低于非肥胖组。LA 时相功能的其他纵向 2D STE 衍生标志物在两组之间无差异。

结论

在射血分数保留且近期无心肌梗死的慢性缺血性心脏病患者中,与非肥胖患者相比,肥胖患者的 2D STE 测量的 LA 储液和收缩功能受损。

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