肥胖对中青年人群心脏结构和功能的影响

Effect of obesity on the cardiac structure and function of the young and middle-aged obese subjects

目的 研究肥胖对我国中青年人群心脏结构和功能的影响。方法 选择 6 7例肥胖者和 2 3名健康者。肥胖者根据体重指数 (BMI)分为三组。采用美国HDI30 0 0彩色多普勒超声心动图仪测量 ,比较各组间心脏结构 (收缩末期左室内径 (LVESD)、舒张末期左室内径 (LVEDD)、室间隔 (IVS)及左室后壁 (LVPW )厚度 ,左室重量 (LVM )和左室重量指数 (LVMI) )和功能 (左室每搏量指数 (SVI) ,射血分数 (EF) ,舒张早期血流充盈峰值流速E、舒张晚期充盈峰值流速A及E/A ,并测量等容舒张时间 (IVRT) )参数。结果 肥胖组同健康组比较 ,LVEDD、LVESD增宽 ,IVS、LVPW增厚 ,LVM、LVMI增加 ,舒张早期充盈峰值流速E降低 ,舒张晚期充盈峰值流速A升高 ,E/A比值降低 ,IVRT延长 ,差异有显著性 (P <0 0 5 )。并随肥胖程度的加重有加重趋势。肥胖组收缩功能参数与健康组比较变化无显著性 (P >0 0 5 )。肥胖组体重指数与LVEDD显著正相关 (r =0 37,P <0 0 5 ) ,与LVM显著正相关 (r =0 5 3,P <0 0 5 ) ,与E/A峰速度比值显著负相关 (r =- 0 2 7,P <0 0 5 )。结论 肥胖可引起中青年人群心脏肥大 ,使中青年人群心脏舒张功能下降 ,并随肥胖程度而加重。

Objective To compare and discuss the changes of cardiac structure and function between young and middle-aged obese and normal healthy subjects.Methods 67 obese objects were divided by the body mass index(BMI)into 3 groups and 23 normal objects were included.Echocardiography was performed using a HDI 3000 and a 2.0～3.0 MHZ transducer.The LV end-diastolic and end-systolic dimension were measured.LV diastolic function was determined by peak E wave velocity,A wave velocity and E/A ratio,IVRT.Results LVEDD,LVESD,IVS,LVMI of obese group were significantly greater,larger than those in control group (P<0.05) and correlated with the degree of the obesity.The E wave velocity and E/A ratio and A wave velocity,IVRT of obese group were lower,higher and longer than those of normal group and correlated with the degree of obesity(P<0.05).There was no significant changes in cardiac systolic variables in obese and normal groups (P>0.05).BMI had significant positive correlation with the LVEDD(r=0.37,P<0.05) and LVM(r=0.53,P<0.05),but negative correlation with the E/A ratio(r=-0.27,P<0.05).Conclusion Obesity can lead to cardiac hypertrophy and cardiac filling dysfunction in young and middle-aged subjects.It correlates with the degree of the obesity.Obesity has no significant influence on cardiac systolic function in young and middle-aged subjects.