Relation of Body Mass Index to Adverse Right Ventricular Mechanics
Relation of Body Mass Index to Adverse Right Ventricular Mechanics
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体重指数与不良右心室力学的关系
DOI：
10.1016/j.amjcard.2020.12.069
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Komuro Issei
中科院分区：
文献类型：
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作者：
Nakanishi Koki;Daimon Masao;Yoshida Yuriko;Ishiwata Jumpei;Sawada Naoko;Hirokawa Megumi;Kaneko Hidehiro;Nakao Tomoko;Mizuno Yoshiko;Morita Hiroyuki;Di Tullio Marco R.;Homma Shunichi;Komuro Issei
虽然较高的体重指数（BMI）与不良的左心室形态和功能重塑有关，但其与右心室（RV）功能障碍的可能相关性尚未得到广泛评价。RV游离壁纵向应变（RVLS）是检测早期RV功能障碍的重要工具。本研究的目的是在无明显心脏病的大样本一般人群中研究BMI增加对RVLS的独立影响。我们检查了1,085名参与者（603名男性，平均年龄62岁），他们自愿接受了广泛的心血管健康检查。这包括实验室检查和斑点追踪超声心动图，以评估RVLS。BMI和RVLS之间的关联通过Logistic回归分析确定。RVLS异常的患病率（>-19.2%）在肥胖个体中最高（29.7%），其次是超重（16.3%）和正常体重（10.6%，p <0.001）。在多变量分析中，BMI与RVLS异常显著相关（校正比值比[OR] = 1.07/1 kg/m2，p = 0.033），与传统心血管风险因素、相关实验室和超声心动图参数（包括RV大小和肺动脉收缩压）无关。在亚组分析中，BMI与男性（调整后OR 1.10/1 kg/m2，p = 0.032）和年轻（<65岁）参与者（调整后OR 1.13/1 kg/m2，p = 0.011）的RVLS异常显著相关，但在女性和老年人中不相关。在一般人群的样本中，较高的BMI与亚临床RV功能障碍独立相关。此外，根据年龄和性别，BMI增加可能会导致RVLS受损的不同风险。
Although higher body mass index (BMI) is associated with adverse left ventricular morphology and functional remodeling, its possible association with right ventricular (RV) dysfunction has not been extensively evaluated. RV free wall longitudinal strain (RVLS) is emerging as an important tool to detect early RV dysfunction. This study aimed to investigate the independent effect of increased BMI on RVLS in a large sample of the general population without overt cardiac disease. We examined 1,085 participants (603 men, mean age 62 years) who voluntarily underwent an extensive cardiovascular health check-up. This included laboratory tests and speckle-tracking echocardiography to assess RVLS. The association between BMI and RVLS was determined by logistic regression analyses. The prevalence of abnormal RVLS (>–19.2%) was greatest in obese individuals (29.7%), followed by overweight (16.3%), and normal weight (10.6%, p <0.001). In multivariable analyses, BMI was significantly associated with abnormal RVLS (adjusted odds ratio [OR] = 1.07 per 1 kg/m2, p = 0.033) independent of traditional cardiovascular risk factors, pertinent laboratory and echocardiographic parameters including RV size and pulmonary artery systolic pressure. In subgroup analyses, BMI was significantly associated with abnormal RVLS in men (adjusted OR 1.10 per 1 kg/m2, p = 0.032) and younger (<65 years) participants (adjusted OR 1.13 per 1 kg/m2, p = 0.011), but not in women and the elderly. In a sample of the general population, higher BMI was independently associated with subclinical RV dysfunction. Furthermore, an increased BMI may carry different risk for impaired RVLS depending on the age and sex.