二维斑点追踪技术联合实时三维超声心动图评价肥胖对原发性高血压患者左房功能影响
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1.南京医科大学附属江宁医院;2.南京医科大学第一附属医院

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国家自然科学基金项目(面上项目,重点项目,重大项目)


Evaluation of the effect of obesity on left atrial function in patients with essential hypertension using two-dimensional speckle tracking imaging combined with real-time three-dimensional echocardiography
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Jiangning Hospital Affiliated to Nanjing Medical University

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    摘要:

    目的:联合应用二维斑点追踪技术(two-dimensional speckle tracking imaging, 2D-STI)和实时三维超声心动图(real-time three-dimensional echocardiography, RT-3DE)评估肥胖对原发性高血压患者左房功能影响。方法:根据体质量分数(body mass index, BMI),将2022年4月至2023年7月在南京市江宁医院确诊的132例原发性高血压患者及114例血压正常对照组分为六个亚组。利用2D-STI 联合RT-3DE技术获得左房纵向应变及机械功能指数,比较各组间左房功能差异。结果:与相同BMI分类的对照组相比,高血压组左房储备期应变(left artial strain in the reservoir phase,LASr)、左房导管期应变(left artial strain in the ductal phase ,LAScd)均下降(P<0.05);随肥胖进展,正常血压对照组与高血压组LASr、LAScd、左房总排空分数(left atrial total ejection fraction,LAEFt)、左房被动排空分数(left atrial postive ejection fraction,LAEFp)、左房主动排空分数(left atrial active ejection fraction,LAEFa)均降低(P<0.05),而左房收缩期应变(left artial strain in the contraction phase,LASct)无明显差异(P>0.05)。多元线性回归显示BMI与高血压组LASr、LAScd、LAEFt、LAEFp、LAEFa均呈独立负相关(P<0.05),而收缩压与高血压患者左房功能均无明显相关(P>0.05)。结论:高血压与肥胖均可引起左房功能受损,肥胖会加重高血压患者左房功能损伤。

    Abstract:

    Abstract: Objective: To evaluate the effect of obesity on left atrial function in patients with essential hypertension by using two-dimensional speckle tracking imaging and real-time three-dimensional echocardiography. Methods:A total of 132 patients with essential hypertension and 114 controls with normal blood pressure were enrolled from Jiangning Hospital Affiliated to Nanjing Medical University from April 2022 to July 2023. According to the body mass index (BMI), they were stratified into six subgroups.The longitudinal strain and mechanical function index of left atrium were obtained by 2D-STI combined with RT-3DE technology, and the parameters above were analized and compared among the six groups. Results:Compared with the controls in the same BMI category,LASr and LAScd in hypertension patients were significantly decreased (P < 0.05),with the aggravation of obesity,LASr, LAScd, LAEFt, LAEFp, LAEFa decreased in both hypertension patients and the controls (P < 0.05),Multivariate linear regression analysis showed that BMI was independently negatively correlated with LASr, LAScd, LAEFt,LAEFp and LAEFa (P < 0.05), but not with LASct (P > 0.05). Conclusion: Both Hypertension and obesity can lead to the impairment of left atrial function and obesity can aggravate the disfunction of left atrium in patients with hypertension.

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  • 收稿日期:2023-09-12
  • 最后修改日期:2024-01-30
  • 录用日期:2024-02-26
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