Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
PLoS One. 2022 Dec 1;17(12):e0278308. doi: 10.1371/journal.pone.0278308. eCollection 2022.
In young adults, overweight and hypertension possibly already trigger cardiac remodeling as seen in mature adults, potentially overlapping non-ischemic cardiomyopathy findings. To this end, in young overweight and hypertensive adults, we aimed to investigate changes in left ventricular mass (LVM) and cardiac volumes, and the impact of different body scales for indexation. We also aimed to explore the presence of myocardial fibrosis, fat and edema, and changes in cellular mass with extracellular volume (ECV), T1 and T2 tissue characteristics. We prospectively recruited 126 asymptomatic subjects (51% male) aged 27-41 years for 3T cardiac magnetic resonance imaging: 40 controls, 40 overweight, 17 hypertensive and 29 hypertensive overweight. Myocyte mass was calculated as (100%-ECV) * height2.7-indexed LVM. Absolute LVM was significantly increased in overweight, hypertensive and hypertensive overweight groups (104 ± 23, 109 ± 27, 112 ± 26 g) versus controls (87 ± 21 g), with similar volumes. Body surface area (BSA) indexation resulted in LVM normalization in overweights (48 ± 8 g/m2) versus controls (47 ± 9 g/m2), but not in hypertensives (55 ± 9 g/m2) and hypertensive overweights (52 ± 9 g/m2). BSA-indexation overly decreased volumes in overweight versus normal-weight (LV end-diastolic volume; 80 ± 14 versus 92 ± 13 ml/m2), where height2.7-indexation did not. All risk groups had lower ECV (23 ± 2%, 23 ± 2%, 23 ± 3%) than controls (25 ± 2%) (P = 0.006, P = 0.113, P = 0.039), indicating increased myocyte mass (16.9 ± 2.7, 16.5 ± 2.3, 18.1 ± 3.5 versus 14.0 ± 2.9 g/m2.7). Native T1 values were similar. Lower T2 values in the hypertensive overweight group related to heart rate. In conclusion, BSA-indexation masks hypertrophy and causes volume overcorrection in overweight subjects compared to controls, height2.7-indexation therefore seems advisable.
在年轻人中，超重和高血压可能已经引发了与成年人心肌重构相似的改变，潜在地重叠了非缺血性心肌病的发现。为此，在年轻的超重和高血压成年人中，我们旨在研究左心室质量（LVM）和心脏容积的变化，以及不同身体指标对指数的影响。我们还旨在探索心肌纤维化、脂肪和水肿的存在，以及细胞质量随细胞外容积（ECV）、T1 和 T2 组织特征的变化。我们前瞻性地招募了 126 名无症状受试者（51%为男性），年龄为 27-41 岁，进行了 3T 心脏磁共振成像检查：40 名对照者、40 名超重者、17 名高血压者和 29 名高血压超重者。心肌质量计算为（100%-ECV）*身高 2.7-指数 LVM。超重、高血压和高血压超重组的 LVM 绝对值显著增加（104±23、109±27、112±26 克），而对照组为 87±21 克，容积相似。体表面积（BSA）指数化使超重者的 LVM 正常化（48±8g/m2），与对照组（47±9g/m2）相比，但高血压者（55±9g/m2）和高血压超重者（52±9g/m2）则不行。BSA 指数化过度减少了超重者的容积，而不是正常体重者（LV 舒张末期容积；80±14 比 92±13ml/m2），而身高 2.7 指数化则没有。所有风险组的 ECV（23±2%、23±2%、23±3%）均低于对照组（25±2%）（P=0.006、P=0.113、P=0.039），表明心肌质量增加（16.9±2.7、16.5±2.3、18.1±3.5 比 14.0±2.9g/m2.7）。原发性 T1 值相似。高血压超重组的 T2 值较低与心率有关。总之，BSA 指数化掩盖了肥胖者的心肌肥厚，并导致与对照组相比的容积过度矫正，因此身高 2.7 指数化似乎是可取的。
