肥胖和病态肥胖的冠状动脉血管扩张能力-左心室肥厚的发散性血流反应

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-08-25 DOI:10.1016/j.ijcha.2025.101785

Elgin Ozkan , Liya Dai , Farrokh Dehdashti , Kan Liu , Thomas H. Schindler

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引用次数: 0

摘要

研究肥胖（OB）和病态肥胖（MOB）两种不同疾病个体冠状动脉血管舒张容量、左心室肥厚和局部心肌功能之间的关系。方法13n -氨PET/CT测定静息和药理学诱导充血时心肌血流量（MBF）及相应的心肌血流储备（MFR）。分别采用二维超声心动图、经二尖瓣多普勒超声心动图、组织多普勒超声心动图和斑点跟踪超声心动图获取左室质量（LVM）、舒张早期血流(E)、舒张速度（E′）和总纵应变（GLS）。然后根据体重指数（BMI）将患者分为正常体重（NW: BMI 20.0 ~ 24.9 kg/m2, n = 27）、超重（OW: BMI 25.0 ~ 29.9 kg/m2, n = 31）、肥胖（OB: BMI 30.0 ~ 39.9 kg/m2, n = 71）和病态肥胖（MOB: BMI≥40 kg/m2, n = 97）。结果从NW、OW到OB， smfr逐渐降低（2.71±0.84∶2.50±0.67∶2.33±0.63；方差分析p≤0.04），而与NW相比，MOB的smfr再次升高（2.51±0.51∶2.71±0.84,p = 0.70）。在OB和MOB中，MFR分别与E速度（cm/s）呈负相关（r = 0.32, SEE = 0.58, p = 0.02; r = 0.29, SEE = 0.47, p = 0.02）。相反，LVM和GLS与OB的MFR呈显著负相关（r = 0.27, SEE = 0.59, p = 0.05; r = 0.31, SEE = 0.61, p = 0.04），而MOB与MFR无显著负相关（r = 0.13, SEE = 0.49, p = 0.27; r = 0.05, SEE = 0.54, p = 0.73）。值得注意的是，GLS、E-velocity和LVM仍然是MFR的独立预测因子。结论冠状动脉血管扩张剂容量与左室质量和早期心肌收缩功能障碍的不同相关性表明OB和MOB对左室重构的影响不同。

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Coronary vasodilator capacity in obesity and morbid obesity – divergent flow responses with left ventricular hypertrophy

Background

To investigate the relationship between coronary vasodilator capacity, left ventricular hypertrophy, and regional myocardial function in two different disease entities of obese (OB) and morbidly obese (MOB) individuals.

Methods

¹³N-ammonia PET/CT determined myocardial blood flow (MBF) at rest and during pharmacologically induced hyperemia, and corresponding myocardial flow reserve (MFR) with ¹³N-ammonia PET/CT. Left ventricular mass (LVM), early diastolic flow (E), relaxation (e’) velocities, and global longitudinal strain (GLS) were acquired with 2D, trans-mitral Doppler and tissue Doppler, and speckle tracking echocardiography, respectively. Patients were then grouped according to the body mass index (BMI) into normal weight (NW: BMI 20.0–24.9 kg/m², n = 27), overweight (OW: BMI 25.0–29.9 kg/ m², n = 31), obesity (OB: BMI 30.0–39.9 kg/m², n = 71), and morbid obesity (MOB: BMI ≥ 40 kg/m², n = 97).

Results

MFR progressively decreased from NW, OW, to OB (2.71 ± 0.84 vs. 2.50 ± 0.67 and 2.33 ± 0.63; p ≤ 0.04 by ANOVA), while it increased again in MOB comparable to NW (2.51 ± 0.51 vs. 2.71 ± 0.84, p = 0.70). In OB and MOB, MFR was inversely correlated with E velocity (cm/s), respectively (r = 0.32, SEE = 0.58, p = 0.02; and r = 0.29, SEE = 0.47, p = 0.02). Conversely, LVM, and GLS associated significantly and inversely with the MFR in OB (r = 0.27, SEE = 0.59, p = 0.05; and r = 0.31, SEE = 0.61, p = 0.04), but not in MOB, respectively (r = 0.13, SEE = 0.49, p = 0.27; and r = 0.05, SEE = 0.54, p = 0.73). Notably, GLS, E-velocity, and LVM remained independent predictors of MFR.

Conclusion

Divergent associations of coronary vasodilator capacity with left ventricular mass and early myocardial contractile dysfunction outline OB and MOB to affect left ventricular remodeling differently.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.