LEFT-VENTRICULAR DIASTOLIC AND SYSTOLIC FUNCTION IN NORMOTENSIVE OBESE SUBJECTS - INFLUENCE OF DEGREE AND DURATION OF OBESITY
LEFT-VENTRICULAR DIASTOLIC AND SYSTOLIC FUNCTION IN NORMOTENSIVE OBESE SUBJECTS - INFLUENCE OF DEGREE AND DURATION OF OBESITY
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DOI：
10.1093/oxfordjournals.eurheartj.a060249
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发表时间：
1992-06-01
影响因子：
39.3
通讯作者：
LICATA, G
中科院分区：
文献类型：
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作者：
SCAGLIONE, R;DICHIARA, MA;LICATA, G
本研究旨在评估超重和中度肥胖但其他方面健康的受试者以及瘦对照组的收缩和舒张参数，以确定肥胖的程度和持续时间是否会影响左心室功能。共纳入27例受试者，17例超重或中度肥胖，10例瘦型健康受试者。根据体重指数（BMI）和Garrow标准将患者分为三组：瘦对照组（BMI < 25 kg.m−2）;超重组（BMI 25 - 30 kg. m −2）;中度肥胖组（BMI >30 <40 kg. m −2）。使用血池门控放射性核素血管造影测量收缩和舒张参数。评价左室射血分数（EF）、射血峰率（PER）、至PER时间（tPER）、峰值充盈率（PFR）和至PFR时间（tPFR）。PER和PFR值被标准化为舒张末期容积（EDV）。与瘦对照组相比，中度肥胖和超重受试者的EF和PFR均显著降低（P <0.05），两组的tPFR均显著延长（P<0.05）。与瘦对照组相比，仅中度肥胖组PER显著降低（P < 0.05），tPER显著延长（P < 0.05）。与超重者相比，中度肥胖者的特征是L VEF、PER显著升高（P < 0.05），P <0.01肥胖组的BMI与PFR呈负相关（P < 0.05），而PFR和tPFR无相关性（r=-0.56; P<0.05）和EF（r=-0.48; P < 0.05）;肥胖持续时间与PFR呈负相关（r=-0.64; P<0.01）与EF（r=-0.51;多元回归分析显示，PFR值随BMI和肥胖持续时间的增加而降低，但与平均血压和左室射血分数无关。我们的结果表明，舒张功能异常可能代表肥胖对心脏影响的早期表现。
The present study was carried out to evaluate systolic and diastolic parameters in overweight and moderately obese, but otherwise healthy subjects, and in a lean control group, to determine whether degree and duration of obesity can influence left ventricular function. A total of 27 subjects, 17 overweight or with moderate obesity and 10 lean, healthy subjects were included. Patients were divided into three groups according to their body mass index (BMI) and to Garrow's criteria as follows: lean control group (BMI < 25 kg.m−2); overweight subjects (BMI from 25 to 30kg.m−2); moderately obese subjects (BMI >30 < 40kg.m−2).Systolic and diastolic parameters were measured using blood pool gated radionuclide angiography. Left ventricular (LV) ejection fraction (EF), peak ejection rate (PER), time to PER (tPER), peak filling rate (PFR) and time to PFR (tPFR) were evaluated. PER and PFR values were normalized for end-diastolic volume (EDV).EF and PFR were significantly lower (P<0.05) both in moderately obese and in overweight subjects and tPFR was significantly (P<0.05) prolonged in both groups in comparison to lean controls. Only in moderately obese subjects was PER significantly (P < 0.05) decreased and tPER significantly (P < 0.05) prolonged in comparison to lean controls. As compared to overweight individuals, moderately obese subjects.were characterized by a significant decrease (P < 0.05) in L VEF and PER and by a significant increase (P < 0.05) in tPER, without relevant change in PFR and in tPFR.In all the obese subjects BMI was inversely correlated with PFR (r= −0.56; P<0.05) and with EF (r= −0.48; P < 0.05); duration of obesity was inversely correlated with PFR (r=- 0.64; P<0.0l) and with EF(r=- 0.51; P < 0.05).Multiple regression analysis indicated that PFR values decreased with BMI and duration of obesity, but not with mean blood pressure and L VEF.Our results indicate that diastolic abnormalities could represent the early manifestations of the effects of obesity on the heart.