EFFECT OF WEIGHT-LOSS ON CARDIAC CHAMBER SIZE, WALL THICKNESS AND LEFT-VENTRICULAR FUNCTION IN MORBID-OBESITY
EFFECT OF WEIGHT-LOSS ON CARDIAC CHAMBER SIZE, WALL THICKNESS AND LEFT-VENTRICULAR FUNCTION IN MORBID-OBESITY
复制标题
DOI：
10.1016/0002-9149(85)90156-0
复制
发表时间：
1985-01-01
影响因子：
2.8
通讯作者：
KELLY, DL
中科院分区：
文献类型：
--
作者：
ALPERT, MA;TERRY, BE;KELLY, DL
应用M型超声心动图和横断面超声心动图测定62例体重正常的病态肥胖者的心腔大小、室壁厚度和左心室收缩功能。他们的理想体重是他们的两倍，但没有潜在的器质性心脏病和系统性高血压。最初的临床方案包括病史、体检、静息心电图、胸部X光和心电图。此后，每个患者都接受了胃限制。34名患者返回接受超声心动图4.3+-随访。0.3个月。在相当大的重量之后。损失已成定局。全组62例，左室舒张期内径增大24例(39%)，右室内径增大20例(32%)，左房内径增大25例(40%)，室间隔及左后壁增厚35例(56%)。在34名回访的患者中，平均体重。显著下降，从135.+-。8-79.+-6公斤(73。+-。超过理想体重的量的4%)。在术前左室短轴缩短率较低的亚组中(n=13)，平均左心室短轴缩短率从22.+-增加。2%-31.+-2%(P<；0.01)。伴随而来的是平均左室舒张期内径和平均血压的显著降低。病态肥胖患者经常出现心腔扩大、左室肥厚和左心室收缩功能障碍，这些人的左心室收缩功能障碍在体重大幅减轻后可能会得到改善。
Cardiac chamber size, wall thickness and left ventricular (LV) systolic function in morbidly obese patients were determined by M-mode and cross-sectional echocardiography in 62 patients whose body weight was .gtoreq. twice their ideal weight but who were free from underlying organic heart disease and systemic hypertension. The initial clinical protocol consisted of a medical history, physical examination, electrocardiogram at rest, chest X-ray and ECG. Thereafter, each patient underwent gastric restriction. Thirty-four patients returned for follow-up echocardiography 4.3 .+-. 0.3 mo. after substantial weight. loss was achieved. For the whole group (n = 62) and LV internal dimension in diastole was enlarged in 24 (39%), the right ventricular internal dimension was enlarged in 20 (32%), the left atrial dimension was enlarged in 25 (40%) and the ventricular septal and LV posterior wall thickness was increased in 35 (56%). In the 34 patients who returned for follow-up, mean body weight. decreased significantly, from 135 .+-. 8-79 .+-. 6 kg (73 .+-. 4% of the amount over ideal body weight). In the subgroup with low preoperative LV fractional shortening (n = 13), mean LV fractional shortening increased from 22 .+-. 2%-31 .+-. 2% (P < 0.01). This was accompanied by a significant decrease in the mean LV internal dimension in diastole and mean blood pressure. Cardiac chamber enlargement, LV hypertrophy and LV systolic dysfunction occur frequently in morbidly obese patients and that LV systolic dysfunction in such persons may improve following substantial weight loss.