三维斑点追踪技术评价腹型肥胖患者左室整体心肌应变的改变

Evaluation of left ventricular global myocardial deformational changes in abdominal obese subjects by three-dimensional speckle tracking echocardiography

目的:应用超声三维斑点追踪技术评价腹型肥胖患者左室整体心肌应变及形态结构的改变,探讨其临床应用价值。方法:选择40例健康对照者、42例腹型肥胖患者(AO组)、41例代谢综合征患者(MS组),测量各组的腰围(WC)、腰臀比(WHR),采用超声三维斑点追踪技术测量左室球形指数(LV SpI)、左室质量(LV Mass)、左室整体收缩期峰值纵向应变(GLS)、圆周应变(GCS)、径向应变(GRS)及面积应变(GAS),比较3组间上述各参数的差异。结果:与对照组比较,AO组的LV SpI减低、LV Mass增大、GLS减低(P<0.01),而GCS、GRS及GAS差异均无统计学意义(P>0.05)。与MS组比较,AO组GLS、GCS及GAS的差异均有统计学意义(P<0.01)。AO组的GLS与WC、WHR及LV Mass呈显著正相关(r=0.558、0.572、0.443,P<0.05)。结论:三维斑点追踪技术可早期检测腹型肥胖患者左室整体收缩功能和形态结构的改变,纵向应变的降低与腹型肥胖的程度及左室重构有关。

Objective：To assess the value of evaluation of left ventricular geometry and global myocardial deformational changes in patients with abdominal obesity by three-dimensional speckle tracking echocardiography（3DSTI）.Method：The 40 healthy subjects,42 abdominal obese subjects（AO group）and 41 metabolic syndrome subjects（MS group）were recruited in this study.Their waist circumference（WC）and waist-to-hip ratio（WHR）were calculated and the myocardial motions were tracking by 3D-STI.The parameters of left ventricular sphericity index（LV SpI）,LV mass,global peak systolic longitudinal strain（GLS）,circular strain（GCS）,radial strain（GRS）and area strain（GAS）were compared among the three groups.Result：Compared with the controls,LVSpI and GLS were decreased and LVmass was increased in AO group.Whereas GCS,GRS and GAS showed no significant difference between the two groups.Compared with the MS group,GLS,GCS and GAS in AO group were significantly higher.In abdominal obese subjects,GLS was positive correlated with WC,WHR and LV mass（r=0.558,0.572,0.443,P〈0.05,respectively）.Conclusion：3D-STI can early evaluate the changes of left ventricular geometry and global systolic function in patients with abdominal obesity,and the impaired longitudinal strain is related to the level of abdominal obesity and left ventricular remolding.