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目的应用实时三维超声心动图(RT-3DE)探讨肥胖和超重对左房(LA)容积和功能的影响。方法按体质量指数(BMI)将120例健康体检者分为三组:肥胖组、超重组和对照组,应用RT-3DE检测左房最大容积(LAVmax)、左房收缩前容积(LAVp)及左房最小容积(LAVmin),计算并比较各组间左房容积指数(LAVI)、LA总排空容积(LATEV)、LA总排空指数(LAEFt)、LA被动排空容积(LAPEV)、LA被动排空指数(LAEFp)、LA主动排空容积(LAAEV)、LA主动排空指数(LAEFa)。分析N末端脑利钠肽前体(NT-proBNP)和左房容积及功能指标的相关性。结果 (1)对照组、超重组及肥胖组的LA容积指标(LAVmax、LAVp、LAVmin、LAVI)依次增大,储存功能指标(LATEV)和LA泵功能指标(LAAEV、LAEFa)依次增大,而LA传导功能指标(LAEFp)则依次减小。(2)肥胖组NTproBNP水平稍高于超重组和对照组,差异无统计学意义。NT-proBNP与LAVI、LAVmax、LAVmin、LATEV及LAAEV具有一定相关性。结论肥胖及超重可在无心血管疾病症状前引起左房结构和机械功能受损。RT-3DE可以灵敏地检测出上述亚临床改变。
Objective To investigate the effect of obesity and overweight on left ventricular (LA) volume and function using real-time three-dimensional echocardiography (RT-3DE). Methods According to the body mass index (BMI), 120 healthy subjects were divided into three groups: obese group, overweight group and control group. The left atrium volume (LAVmax), LAVp LAVI, LATEV, LAEFt, LAPEV and LA were calculated and compared between the two groups. The left atrial minimum volume (LAVmin) Passive Emptying Index (LAEFp), LA Active Vacancy Volume (LAAEV), LA Active Vacancy Index (LAEFa). The correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP) and left atrium volume and function was analyzed. Results (1) LA volume index (LAVmax, LAVp, LAVmin, LAVI) of control group, overweight group and obesity group increased in sequence, LATEV and LAAEa increased gradually LA conduction function index (LAEFp) decreased in turn. (2) The level of NTproBNP in obesity group was slightly higher than that in overweight group and control group, with no significant difference. NT-proBNP has some correlation with LAVI, LAVmax, LAVmin, LATEV and LAAEV. Conclusion Obesity and overweight may cause left atrial structural and mechanical impairment before symptoms of cardiovascular disease. RT-3DE can sensitively detect the above subclinical changes.