超重及肥胖对老年高血压左室心肌力学的影响

The effects of overweight and obesity on left ventricular myocardial strain in elderly patients with arterial hypertension

目的:应用二维斑点追踪技术(2D-STE)评价老年高血压合并超重及肥胖时左心室的心肌功能。方法:选取老年高血压118例为高血压组,根据体质量指数(BMI)界限值将其分亚组为正常体重组、超重组及肥胖组。选取健康老年志愿者40例作为对照组。应用二维斑点追踪超声心动图采集图像,存储并脱机分析图像后,比较四组间左心室心内膜层(EndLS)、心肌中层(MidLS)、心外膜层(EpiLS)及整体心肌纵向应变(GLS)。结果:与对照组相比,高血压组GLS均降低(P<0.05);与对照组比较,正常体重组EndLS降低(P<0.05),MidLS及EpiLS无明显变化(P>0.05);与对照组和正常体重组比较,超重组GLS、EndLS、MidLS降低(P<0.05),EpiLS无明显变化(P>0.05)。与对照组、正常体重组及超重组比较,肥胖组GLS、EndLS、MidLS、EpiLS进一步降低(P<0.05)。结论:二维斑点追踪技术可早期、定量地评价超重及肥胖对老年高血压左心室心肌功能的影响,具有一定的临床应用价值。

Objective:To evaluate the function of left ventricular(LV)myocardium in elderly arterial hypertension patients with overweight and obesity by two-dimensional speckle tracking echocardiography(2D-STE).Methods:One hundred and eighteen cases of elderly patients with arterial hypertension were enrolled.The hypertensive patients were grouped into normal weight,overweight and obesity group on the basis of BMI.The control group included 40 healthy volunteers.Four groups were all assessed by 2D-STE.Longitudinal strain of the LV subendocardial myocardium(EndLS),mid myocardium(MidLS),subepi-cardial myocardium(EpiLS)and global longitudinal strain(GLS)were acquired after image collection and analysis.Results:Compared with the control group,GLS decreased in the hypertension group(P<0.05).EndLS of the normal weight group was lower than the control group(P<0.05),and there was no significant difference in MidLS and EpiLS(P>0.05).The overweight group had lower GLS,EndLS and MidLS than the control group and normal weight group(P<0.05),but EpiLS showed no significance(P>0.05).Compared with the control group,normal weight group and overweight group,the GLS,EndLS,MidLS and EpiLS of the obesity group further reduced(P<0.05).Conclusion:2D-STE can quantitatively assess the effects of overweight and obesity on LV myocardial function in senile hypertension at an early stage,which might provide a certain clinical value.