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肥胖对心肌变形的影响:超重至肥胖但无既定心血管疾病人群的心血管磁共振特征追踪研究。

Adiposity influences on myocardial deformation: a cardiovascular magnetic resonance feature tracking study in people with overweight to obesity without established cardiovascular disease.

机构信息

Charité Universitätsmedizin Berlin, Working Group on Cardiovascular Magnetic Resonance, Experimental and Clinical Research Center, A Joint Cooperation Between the Charité Universitätsmedizin Berlin and the Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.

DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany.

出版信息

Int J Cardiovasc Imaging. 2024 Mar;40(3):643-654. doi: 10.1007/s10554-023-03034-2. Epub 2024 Feb 2.

Abstract

The objective of this study was to assess whether dietary-induced weight loss improves myocardial deformation in people with overweight to obesity without established cardiovascular disease applying cardiovascular magnetic resonance (CMR) with feature tracking (FT) based strain analysis. Ninety people with overweight to obesity without established cardiovascular disease (age 44.6 ± 9.3 years, body mass index (BMI) 32.6 ± 4 kg/m) underwent CMR. We retrospectively quantified FT based strain and LA size and function at baseline and after a 6-month hypocaloric diet, with either low-carbohydrate or low-fat intake. The study cohort was compared to thirty-four healthy normal-weight controls (age 40.8 ± 16.0 years, BMI 22.5 ± 1.4 kg/m). At baseline, the study cohort with overweight to obesity without established cardiovascular disease displayed significantly increased global circumferential strain (GCS), global radial strain (GRS) and LA size (all p < 0.0001 versus controls) but normal global longitudinal strain (GLS) and normal LA ejection fraction (all p > 0.05 versus controls). Dietary-induced weight loss led to a significant reduction in GCS, GRS and LA size irrespective of macronutrient composition (all p < 0.01). In a population with overweight to obesity without established cardiovascular disease subclinical myocardial changes can be detected applying CMR. After dietary-induced weight loss improvement of myocardial deformation could be shown. A potential clinical impact needs further studies.

摘要

本研究旨在评估饮食诱导的体重减轻是否能改善超重至肥胖但无心血管疾病的人群的心肌变形,方法是应用基于特征追踪(FT)的心肌应变分析的心血管磁共振(CMR)。90 名超重至肥胖但无心血管疾病(年龄 44.6±9.3 岁,BMI 32.6±4kg/m)的患者接受了 CMR 检查。我们回顾性地在基线时和 6 个月的低热量饮食后,使用低碳水化合物或低脂肪饮食,对 FT 基于应变和左心房(LA)大小和功能进行了定量分析。将研究队列与 34 名健康的正常体重对照者(年龄 40.8±16.0 岁,BMI 22.5±1.4kg/m)进行了比较。在基线时,无心血管疾病的超重至肥胖的研究队列显示出明显的整体周向应变(GCS)、整体径向应变(GRS)和 LA 增大(与对照组相比,所有 p 值均<0.0001),但整体纵向应变(GLS)和 LA 射血分数(EF)正常(与对照组相比,所有 p 值均>0.05)。无论宏量营养素组成如何,饮食诱导的体重减轻都会导致 GCS、GRS 和 LA 大小的显著减少(所有 p 值均<0.01)。在超重至肥胖且无心血管疾病的人群中,应用 CMR 可以检测到亚临床心肌变化。在饮食诱导的体重减轻后,心肌变形得到了改善。这一潜在的临床影响需要进一步的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf81/10951011/ad4b87afeb09/10554_2023_3034_Fig1_HTML.jpg

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