Faculty of Medicine, Department of Cardiology, Gazi University, Ankara, Turkey.
Int J Cardiovasc Imaging. 2024 Feb;40(2):407-414. doi: 10.1007/s10554-023-03008-4. Epub 2023 Nov 13.
Obesity is a risk factor for various cardiovascular disorders. Left atrial (LA) function is vital for predicting adverse outcomes in many diseases. LA strain was recently proposed as a noninvasive and valuable parameter for LA functional evaluation. We investigated the effect of body mass index (BMI) values on left atrial functions determined by longitudinal strain analysis in young adults without concomitant disease.
We prospectively included 134 subjects in our study. Participants were categorized into three subgroups, obese, overweight, and control, according to their BMI. Conventional echocardiographic measurements and strain analysis were performed on all patients.
There were 41 patients (30.5%) in the obesity group, 46 patients (34.3%) in the overweight group, and 47 patients (35.0%) in the control group. Obese patients had significantly larger LA volume (46.9 ± 12.1 ml; p < 0.001) compared to overweight and control subjects; however, LA volume index (21.4 ± 6.1 ml/m vs. 22.4 ± 6.1 ml/m vs. 22.4 ± 5.0 ml/m; p = 0.652) were similar between groups. In the LA strain analysis, obese patients were found to have lower left atrial reservoir longitudinal strain (LASr) compared to both the overweight and control group (44.2 ± 5.8% vs. 39.1 ± 3.7% vs. 36.5 ± 4.9%; p < 0.001); moreover obese patients had significantly worse left atrial contraction phase longitudinal strain (LASct) (-15.1 ± 3.1% vs. -13.1 ± 2.5%; p = 0.007) and left atrial conduit phase longitudinal strain (LAScd) (-29.0 ± 7.1% vs. -23.3 ± 5.4%; p < 0.001) values compared to the control group. However, LASct and LAScd values did not differ between overweight and obese patients.
LA function determined by LA strain analysis was impaired in obese and overweight individuals compared to the control group, even in the early stages of life. The prognostic significance of this finding should be investigated in prospective studies.
肥胖是多种心血管疾病的危险因素。左心房（LA）功能对于预测许多疾病的不良结局至关重要。LA 应变最近被提出作为 LA 功能评估的一种非侵入性和有价值的参数。我们研究了在没有合并症的年轻成年人中，通过纵向应变分析确定的左心房功能与体重指数（BMI）值的关系。
我们前瞻性地纳入了 134 名研究对象。根据 BMI，将参与者分为三组：肥胖组、超重组和对照组。对所有患者进行常规超声心动图测量和应变分析。
肥胖组有 41 名患者（30.5%），超重组有 46 名患者（34.3%），对照组有 47 名患者（35.0%）。与超重和对照组相比，肥胖组患者的左心房容积明显更大（46.9±12.1ml;p<0.001）；然而，左心房容积指数（21.4±6.1ml/m 与 22.4±6.1ml/m 与 22.4±5.0ml/m;p=0.652）在各组之间相似。在 LA 应变分析中，与超重和对照组相比，肥胖患者的左心房储备纵向应变（LASr）较低（44.2±5.8%与 39.1±3.7%与 36.5±4.9%;p<0.001）；此外，肥胖患者的左心房收缩期纵向应变（LASct）（-15.1±3.1%与-13.1±2.5%;p=0.007）和左心房传导期纵向应变（LAScd）（-29.0±7.1%与-23.3±5.4%;p<0.001）值明显更差。然而，超重和肥胖患者之间的 LASct 和 LAScd 值没有差异。
与对照组相比，肥胖和超重个体的 LA 功能通过 LA 应变分析确定受损，即使在生命的早期阶段也是如此。这一发现的预后意义应在前瞻性研究中进行调查。
