组织运动瓣环位移技术定量评价单纯腹型肥胖患者左心室长轴收缩功能

Quantitative assessment of left ventricular long axis systolic function in patients with abdominal obesity using tissue mitral annular displacement

目的应用组织运动瓣环位移（TMAD）技术定量评价腹型肥胖患者左心室整体长轴收缩功能，并探讨左心室整体长轴功能与肥胖程度的相关性。方法对38例腹型肥胖患者和34例健康成人行超声心动图检查，获取心尖四腔观、心尖二腔观图像，应用TMAD技术测量二尖瓣环4个位点收缩期最大位移（MADs）、二尖瓣环中点收缩期最大位移（MAD-midpt）、二尖瓣环中点收缩期标准化位移（MAND-midpt）以及双平面法测量的二尖瓣环中点收缩期标准化位移（MABND-midpt），比较两组上述参数值，并行腰臀比（WHR）与二尖瓣环位移相关指标的相关性分析。结果与对照组相比，腹型肥胖组四个位点MADs低于对照组（P值均〈0．001），心尖四腔观、心尖两腔观MAD-midpt、MAND-midpt及MABND-midpt均低于对照组（P均〈0．001）。相关性分析显示，WHR与MADs均值（r=-0．663，P=0．000）、MABND—midpt（r=-0．716，P=0．000）均呈线性负相关，控制年龄和身高因素，WHR与MABND-midpt仍呈线性负相关（偏相关系数r=-0．697，P=0．000）。结论腹型肥胖患者左心室整体长轴收缩功能明显受损，TMAD可定量评价腹型肥胖患者左心室整体长轴收缩功能。

Objective To evaluate the value of tissue mitral annular displacement （TMAD） in the assessment of left ventricular long axis systolic function and the relationship of obese degree with left ventricular long axis systolic function in patients with abdominal obesity. Methods Thirty-eight abdominal obesity cases and thirty-four healthy cases were investigated using echocardiography. The images of apical four-chamber view and apical two-chamber view were obtained, systolic mitral annular displacement （MADs） ,mid-point of mitral annular displacement（MAD-midpt）, mid-point of mitral annular normalized displacement（MAND-midpt） and mid-point of mitral annular biplanar normalized displacement（MABND- midpt） were measured by the technique of TMAD. Their characteristics between patients with abdominal obesity and healthy group were compared,and the relationship of waist-hip ratio（WHR） and related indexes of MAD were analyzed. Results In abdominal obesity group, the MADs at the four site were significantly decreased compared with control group （ P 〈0. 001, respectively）, the MAD-midpt and MAND- midpt of apical four-chamber view and apical two-chamber view were significantly decreased compared with control group （ P 〈0. 001, respectively）. The WHR related with MABND-midpt independently by the analysis of partial correlation（ r = - 0. 697, P = 0. 000）. Conclusions The left ventricular long axis systolic function were damaged in patients with abdominal obesity. The technique of TMAD could quantitatively assess the left ventricular long axis systolic function in patients with abdominal obesity.