应用新型碲锌镉心脏专用SPECT相位分析评价肥胖患者的左心室机械收缩同步性
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南京医科大学第一附属医院心血管内科,江苏 南京 210029

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R817.4;R541

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国家自然科学基金(82100338)


Evaluation of left ventricular mechanical contraction synchrony in obese patients using a novel CZT SPECT
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Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029 ,China

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    摘要:

    目的:探讨肥胖对心肌灌注显像正常患者群体的左心室机械收缩同步性参数的影响。方法:回顾性分析2023年1月— 2024年8月在南京医科大学第一附属医院接受碲锌镉心脏专用单光子发射计算机断层成像(cadmium zinc telluride single photon emission computed tomography,CZT SPECT)心肌灌注显像的患者,选取心肌灌注显像结果和左心室射血分数均正常的患者 133 例,根据体重指数(body mass index,BMI)分为 3 组:正常组(18.5 kg/m2 ≤BMI<24.0 kg/m2 )40 例,超重组(24.0 kg/m2 ≤BMI< 28.0 kg/m2 )45 例,肥胖组(BMI≥28.0 kg/m2 )48例。分析比较3组患者之间相位直方图带宽(phase histogram bandwidth,PBW)、 相位标准差(phase standard deviation,PSD)、舒张末期容积(end-diastolic volume,EDV)、收缩末期容积(end-systolic volume, ESV)、左心室射血分数(left ventricular ejection fraction,LVEF)等左心室功能参数的差异,并探讨 BMI 对这些参数的影响。 结果:超重组和肥胖组PBW值[(22.00±4.24)vs.(17.10±3.20),P < 0.001;(26.13±5.74)vs.(17.10±3.20),P < 0.001)]和PSD值 [(5.04±1.05)vs.(3.74±0.68),P < 0.001;(6.34±1.43)vs.(3.74±0.68),P < 0.001)]均显著高于正常组。肥胖组PBW值[(26.13± 5.74)vs.(22.00±4.24),P < 0.001)]和PSD值[(6.34±1.43)vs.(5.04±1.05),P < 0.001)]均显著高于超重组。超重和肥胖患者的 PBW值(r=0.446,P < 0.001)和PSD值(r=0.477,P < 0.001)与BMI呈显著正相关。结论:肥胖患者更容易发生左心室机械收缩不同步(left ventricular mechanical dyssynchrony,LVMD),新型碲锌镉心脏专用SPECT相位分析可早期有效评估肥胖患者的左心室机械收缩同步性,对于肥胖患者早期发现LVMD并进行干预以降低心血管事件具有重要的临床指导意义。

    Abstract:

    Objective:To investigate the impact of obesity on left ventricular mechanical contraction synchrony parameters in patients with normal myocardial perfusion imaging(MPI). Methods:A retrospective analysis was conducted on patients who underwent cadmium zinc telluride single photon emission computed tomography(CZT SPECT)MPI at the First Affiliated Hospital of Nanjing Medical University from January 2023 to August 2024. A total of 133 patients with both normal MPI results and normal left ventricular ejection fraction(LVEF)were selected. They were divided into three groups based on body mass index(BMI):normal group(18.5 kg/m2 ≤ BMI<24.0 kg/m2n=40),overweight group(24.0 kg/m2 ≤BMI<28.0 kg/m2n=45),and obese group(BMI≥28.0 kg/m2n=48). The differences in left ventricular function parameters such as phase histogram bandwidth(PBW),phase standard deviation(PSD),end - diastolic volume(EDV),end-systolic volume(ESV),and LVEF among the three groups were compared. The relationship between BMI and these parameters was analyzed. Results:Both overweight and obese groups showed significantly higher PBW(22.00 ± 4.24)vs. (17.10±3.20),P < 0.001;(26.13±5.74)vs(. 17.10±3.20),P < 0.001)and PSD values(5.04±1.05)vs.(3.74±0.68),P < 0.001;(6.34± 1.43)vs.(3.74±0.68),P < 0.001)compared with the normal group. The obese group demonstrated significantly greater PBW(26.13± 5.74)vs.(22.00±4.24),P < 0.001)and PSD(6.34±1.43)vs.(5.04±1.05),P < 0.001)than the overweight group. PBW(r=0.446,P <0.001)and PSD(r=0.477,P < 0.001)showed significant positive correlations with BMI in overweight and obese patients. Conclusion: Obese patients are more likely to develop left ventricular mechanical dyssynchrony(LVMD),and the novel CZT SPECT phase analysis technique can effectively evaluate left ventricular mechanical synchrony in obese patients at an early stage,providing important clinical guidance for early detection and intervention of LVMD to reduce cardiovascular events in this population.

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卜菊,王骋,李春香,赵中强.应用新型碲锌镉心脏专用SPECT相位分析评价肥胖患者的左心室机械收缩同步性[J].南京医科大学学报(自然科学版),2025,45(10):1487-1493

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  • 收稿日期:2025-01-06
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  • 在线发布日期: 2025-10-16
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