JAHA:伴有非酒精性脂肪性肝炎的肥胖患者心脏形态、功能和血流动力学改变

2021-04-13 MedSci原创 MedSci原创

极端肥胖患者,NASH与左心室向心性重塑和循环高压力相关。伴有心输出量增加的NASH可能是该人群发生心血管事件的另一个危险因素。

非酒精性脂肪肝患者血管风险增加。肝功能异常对心脏功能的不利影响是这种关联背后许多推测机制之一。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,这项旨在评估接受减肥手术并进行肝脏活检的肥胖患者的心脏形态和功能。

研究人员通过超声心动图评估了171例连续就诊的无明确心脏疾病的患者(中位年龄为42岁[四分位间距37-48]),体重指数中位数为43.7 [四分位间距为41.0-47.5],女性患者为67%;根据肝活检结果,非酒精性脂肪性肝炎(NASH)患者为44例,单纯脂肪变性患者为69例,无脂肪变性患者为58例。

NASH患者表现出左心室向心性重塑和循环高压力,包括左室舒张末期直径指数[cm/m2]:NASH患者为1.87 [0.22];单纯性脂肪变性患者为2.03 [0.33];无脂肪变性患者为2.01 [0.19],P=0.001;室壁相对厚度:NASH患者为0.49±0.05,单纯性脂肪变性患者为0.47±0.06,无脂肪变性患者为0.46±0.06,P=0.011;心指数[L/m2]:NASH患者为3.05±0.54,单纯性脂肪变性患者为2. 80±0.44,无脂肪变性患者为2.79±0.50,P=0.013。在调整了性别、年龄、血压和心率后,两组左心室收缩和舒张功能、左心房大小、右心室功能和右心室大小的大多数测量指标均无差异。

由此可见,极端肥胖患者,NASH与左心室向心性重塑和循环高压力相关。伴有心输出量增加的NASH可能是该人群发生心血管事件的另一个危险因素。

原始出处:

Grzegorz Styczynski.et al.Cardiac Morphology, Function, and Hemodynamics in Patients With Morbid Obesity and Nonalcoholic Steatohepatitis.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.120.017371

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    2022-02-17 qjddjq
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    2021-04-15 zhaohui6731
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    2021-04-15 ms9000000028407387

    学习

    0

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