Huang Shan, Li Yuan, Shi Ke, Wang Jin, Jiang Li, Gao Yue, Yan Wei-Feng, Yang Zhi-Gang
Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Magn Reson Imaging. 2023 Jun;57(6):1743-1751. doi: 10.1002/jmri.28455. Epub 2022 Oct 5.
Metabolic and hemodynamic alterations in metabolic syndrome (MetS) can cause a reduced myocardial energetic efficiency (MEE). Indexed MEE (MEEi), as a simple estimate of MEE, is emerging as a novel and useful imaging parameter.
To investigate the impact of MetS on MEE and systolic myocardial strain and to assess any sex difference.
Retrospective.
A total of 161 patients with MetS (female: n = 82, 52.2 ± 11.7 years; male: n = 79, 51.8 ± 10.6 years) and 77 healthy subjects (female: n = 46, 52.7 ± 8.2 years; male: n = 31, 54.1 ± 11.2 years). Patients with left ventricular (LV) ejection fraction <50% were excluded.
FIELD STRENGTH/SEQUENCE: A 3.0 T; balanced steady-state free precession sequence.
LV volumes and mass (LVM) and global longitudinal strain (GLS) were obtained by MRI. Stroke volume (SV) divided by HR was used as a surrogate measure of MEE and normalized to LVM (MEEi).
Student's t-test or Mann-Whitney U-test; Multivariable linear regression (coefficient of determination, R ). P < 0.05 was considered statistically significant.
For both males and females, MEEi and GLS were lower in MetS patients than in the normal controls. Among MetS patients, men had significantly higher LVM (59.7 ± 13.4 g/m vs. 48.8 ± 11.3 g/m ) and significantly lower MEEi (0.68 ± 0.23 mL/g/s vs. 0.84 ± 0.23 mL/g/s) and GLS (-11.7% ± 2.8% vs. -13.9% ± 2.7%) than women. After adjustment for clinical variables, male gender (β = -0.291) was found to be inversely correlated with MEEi. Multivariable analysis showed that MEEi (β = 0.454) were independently associated with GLS (adjusted R = 0.454) after adjustment for clinical and other MRI parameters.
MEEi was significantly impaired in MetS without overt systolic dysfunction. There was a sex difference regarding the cardiac alterations in MetS, with men having significantly lower MEEi and GLS and significantly higher LVM than women. Further, MEEi was independently associated with GLS.
3 TECHNICAL EFFICACY: Stage 3.
代谢综合征（MetS）中的代谢和血流动力学改变可导致心肌能量效率（MEE）降低。作为MEE的一种简单估计指标，指数化心肌能量效率（MEEi）正成为一种新颖且有用的成像参数。
研究MetS对MEE和收缩期心肌应变的影响，并评估性别差异。
回顾性研究。
共161例MetS患者（女性：n = 82，年龄52.2±11.7岁；男性：n = 79，年龄51.8±10.6岁）和77名健康受试者（女性：n = 46，年龄52.7±8.2岁；男性：n = 31，年龄54.1±11.2岁）。排除左心室（LV）射血分数<50%的患者。
场强/序列：3.0T；平衡稳态自由进动序列。
通过MRI获得LV容积、质量（LVM）和整体纵向应变（GLS）。每搏输出量（SV）除以心率用作MEE的替代指标，并根据LVM进行标准化（MEEi）。
学生t检验或曼-惠特尼U检验；多变量线性回归（决定系数，R）。P<0.05被认为具有统计学意义。
对于男性和女性，MetS患者中的MEEi和GLS均低于正常对照组。在MetS患者中，男性的LVM显著更高（59.7±13.4g/m²对48.8±11.3g/m²），MEEi显著更低（0.68±0.23mL/g/s对0.84±0.23mL/g/s），GLS也显著更低（-11.7%±2.8%对-13.9%±2.7%）。在对临床变量进行调整后，发现男性性别（β = -0.291）与MEEi呈负相关。多变量分析显示，在对临床和其他MRI参数进行调整后，MEEi（β = 0.454）与GLS独立相关（调整后的R² = 0.454）。
在无明显收缩功能障碍的MetS患者中，MEEi显著受损。MetS患者的心脏改变存在性别差异，男性的MEEi和GLS显著低于女性，LVM显著高于女性。此外，MEEi与GLS独立相关。
3级 技术效能：3级
