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减重手术后肥胖患者心脏的结构、功能及脂肪含量变化——一项前瞻性磁共振成像研究

Changes in the Structure, Function, and Fat Content of the Heart in Patients with Obesity After Bariatric Surgery-A Prospective Magnetic Resonance Imaging Study.

作者信息

Bai Jinquan, Li Xiaolu, Shi Zhenzhou, Pan Hong, Wang Shuting, Gao Chao, Zhao Min, Yue Xiuzheng, Yang Kai, Zhang Xia, Liu Chang, Wang Wei, Zhang Tong

机构信息

Department of Radiology, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, YiYuan Street, NanGang District, Harbin, Heilongjiang, 150001, China.

Pharmaceutical Diagnostics, GE Healthcare, No. 1, Tongji South Road, Beijing, 100176, Daxing District, China.

出版信息

Obes Surg. 2025 Jan;35(1):9-18. doi: 10.1007/s11695-024-07254-w. Epub 2024 Dec 6.

Abstract

BACKGROUND

Changes in myocardial fat in addition to changes in cardiac structure and function have not been accurately evaluated in obese patients following surgery.

MATERIALS AND METHODS

Forty-four obese patients who underwent sleeve gastrectomy and completed preoperative and postoperative cardiac magnetic resonance imaging (CMR) before surgery and at 1, 3, and 6 months after surgery were enrolled, and their clinical and laboratory data were collected. The differences and correlations between clinical, laboratory, and CMR parameters between the preoperative and postoperative groups were analysed.

RESULTS

The left ventricular mass (LVM), left ventricle cardiac output (LVCO), pericardial adipose tissue volume (PATV), and myocardial proton density fat fraction (M-PDFF) decreased after surgery (all P < 0.05). The left ventricle global longitudinal strain increased at 6 months after surgery (P = 0.004). A decrease in BMI was positively correlated with the LVCO (r = 0.58, P < 0.001) at 3 months after surgery and was positively correlated with the LVM and PATV (r = 0.54, P < 0.05) at 6 months after surgery. Six months after surgery, the changes in PATV were positively correlated with the changes in triglycerides (r = 0.61, P < 0.01). There was a moderately positive correlation between the decrease in the LVM and PATV (r = 0.54 ~ 0.71, P < 0.02) after surgery.

CONCLUSION

After surgery, the cardiac structure and function of obese patients significantly improved, the PATV and M-PDFF decreased, and there was a correlation between the structure and function of the heart and several clinical and laboratory indicators.

摘要

背景

肥胖患者术后除心脏结构和功能变化外,心肌脂肪的变化尚未得到准确评估。

材料与方法

纳入44例行袖状胃切除术的肥胖患者,他们在术前及术后1个月、3个月和6个月完成了心脏磁共振成像(CMR),并收集了其临床和实验室数据。分析术前和术后组临床、实验室及CMR参数之间的差异和相关性。

结果

术后左心室质量(LVM)、左心室心输出量(LVCO)、心包脂肪组织体积(PATV)和心肌质子密度脂肪分数(M-PDFF)均降低(均P<0.05)。术后6个月左心室整体纵向应变增加(P = 0.004)。术后3个月BMI的降低与LVCO呈正相关(r = 0.58,P<0.001),术后6个月与LVM和PATV呈正相关(r = 0.54,P<0.05)。术后6个月,PATV的变化与甘油三酯的变化呈正相关(r = 0.61,P<0.01)。术后LVM和PATV的降低之间存在中度正相关(r = 0.54~0.71,P<0.02)。

结论

术后肥胖患者的心脏结构和功能显著改善,PATV和M-PDFF降低,心脏结构和功能与多项临床和实验室指标之间存在相关性。

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