[1]朱婷婷,赵晶晶,张佳宇,等.二维斑点追踪成像技术评价肥胖患者减重手术后左心房功能变化的研究[J].心血管病学进展,2026,(3):263.[doi:10.16806/j.cnki.issn.1004-3934.2026.03.015]
 ZHU Tingting,ZHAO Jingjing,ZHANG Jiayu,et al.Evaluation of Changes in Left Atrial Function in Obese Patients After Bariatric Surgery Using Two-Dimensional Speckle Tracking Echocardiography[J].Advances in Cardiovascular Diseases,2026,(3):263.[doi:10.16806/j.cnki.issn.1004-3934.2026.03.015]
点击复制

二维斑点追踪成像技术评价肥胖患者减重手术后左心房功能变化的研究()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2026年3期
页码:
263
栏目:
论著
出版日期:
2026-03-25

文章信息/Info

Title:
Evaluation of Changes in Left Atrial Function in Obese Patients After Bariatric Surgery Using Two-Dimensional Speckle Tracking Echocardiography
作者:
朱婷婷12 赵晶晶12 张佳宇2薛继平2
(1.山西医科大学医学影像学院,山西 太原 030001;2.山西医科大学第三医院/山西白求恩医院超声科,山西 太原 030032)
Author(s):
ZHU Tingting12 ZHAO Jingjing12 ZHANG Jiayu2 Xue Jiping2
(1. School of Medical Imaging,Shanxi Medical University,Taiyuan 030001,Shanxi,China; 2. Department of Ultrasound,Third Hospital of Shanxi Medical University / Shanxi Bethune Hospital,Taiyuan 030032,Shanxi,China) E-mailjipingxue@sina.com
关键词:
肥胖左 心房功能减重手术二维斑点追踪成像技术
Keywords:
Obesity Left atrial function Bariatric surgery Two-dimensional speckle tracking echocardiography
DOI:
10.16806/j.cnki.issn.1004-3934.2026.03.015
摘要:
目的 通过回顾性分析行减重手术的肥胖患者,探讨减重手术前、减重手术后左心房功能变化,为临床治疗和随访提供参考。方法 回顾性选取2021年12月—2023年6月就诊于山西白求恩医院的减重代谢外科的肥胖患者49例作为肥胖组,同期选取年龄、性别相匹配、体重指数(BMI)及血压正常的50例健康人作为对照组。测量对照组及肥胖者基线位、减重6个月后的常规超声心动图参数二尖瓣舒张早期峰值流速与二尖瓣环侧壁和间隔舒张早期速度的平均值之比(平均E/e’)、左心房容积指数(LAVI),采用二维斑点追踪成像技术测量左心房储备期应变(LASr)、左心房管道期应变(LAScd)及左心房收缩期应变(LASct)。比较肥胖组减重手术前、减重手术后6个月及对照组的临床参数、常规超声心动图参数及左心房应变参数,以及分析△BMI与左心房应变参数变化量的相关性。结果 肥胖组基线位的LASr和LAScd小于对照组,LASct大于对照组。减重手术6个月后LASr和LAScd均大于基线位,但仍小于对照组,LASct小于基线位。△BMI与△LASr呈正相关(r=0.496,P<0.001),与△LAScd呈正相关(分别r=0.377,P=0.008),与△LASct无明显相关(r=0.095,P=0.514)。多元线性回归分析结果显示,△BMI是△LASr和△LAScd的独立影响因素(B值分别为0.682和0.270,P均<0.05)。结论 肥胖患者左心房功能受损,减重手术后左心房功能得以改善,且减重手术后BMI的降低程度与左心房功能的改善程度显著相关。
Abstract:
Objective To investigate changes in left atrial function before and after bariatric surgery in obese patients through retrospective analysis ,providing reference for clinical treatment and follow-up. Methods Forty-nine obese patients who underwent bariatric surgery at Shanxi Bethune Hospital between December 2021 and June 2023 were retrospectively enrolled as the obese group. Fifty healthy individuals matched for age and gender ,with normal body mass index (BMI) and blood pressure,were selected as the control group. Conventional echocardiographic parameters were measured in both the control group and the obese group at baseline and 6 months after surgery,including the ratio of mitral valve early diastolic peak flow velocity to the average of early diastolic velocities at the lateral and septal mitral annulus (average E/e’) and left atrial volume index (LAVI). Two-dimensional speckle tracking echocardiography (2D-STE) was used to measure left atrial reservoir strain (LASr),left atrial conduit strain (LAScd),and left atrial contractile strain (LASct). Clinical parameters,conventional echocardiographic parameters,and left atrial strain parameters were compared among the obese group at baseline (pre-surgery),6 months postoperatively,and the control group. The correlation between ΔBMI and changes in left atrial strain parameters was also analyzed. Results At baseline ,LASr and LAScd in the obese group were lower than in the control group,while LASct was higher. Six months after weight loss,LASr and LAScd were significantly higher than at baseline but still lower than in the control group,while LASct was lower than at baseline. ΔBMI was positively correlated with ΔLASr (r =0.496,P<0.001) and positively correlated with ΔLAScd (r=0.377,P=0.008),but showed no significant correlation with ΔLASct (r =﹣0.095,P=0.514). The multiple linear regression analysis revealed that ΔBMI was an independent influencing factor for both ΔLASr and ΔLAScd (B-values = 0.682 and 0.270,respectively; both P<0.05). Conclusion Left atrial function is impaired in obese patients. Bariatric surgery improves left atrial function ,and the degree of post-surgical BMI reduction is significantly correlated with the degree of improvement in left atrial function

参考文献/References:

[1].Kim SH,Després JP,Koh KK. Obesity and cardiovascular disease:friend or foe?[J]. Eur Heart J,2016,37(48):3560-3568.
[2].中国肥胖问题工作组. 中国成人超重和肥胖症预防与控制指南(节录)[J]. 营养学报,2004,26(1):1-4.
[3].Sun X,Yan AF,Shi Z,et al. Health consequences of obesity and projected future obesity health burden in China [J]. Obesity (Silver Spring),2022,30(9):1724-1751.
[4].Aryee EK,Ozkan B,Ndumele CE. Heart failure and obesity:the latest pandemic[J].?Prog Cardiovasc Dis,2023,78:43-48.
[5].daSilva-deAbreu A,Alhafez BA,Lavie CJ,et al. Interactions of hypertension,obesity,left ventricular hypertrophy,and heart failure[J]. Curr Opin Cardiol,2021,36(4):453-460.
[6].Morris DA,Belyavskiy E,Aravind-Kumar R,et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction[J]. JACC Cardiovasc Imaging,2018,11(10):1405-1415.
[7].Alabduljabbar K,Bonanos E,Miras AD,et al. Mechanisms of action of bariatric surgery on body weight regulation[J]. Gastroenterol Clin North Am ,2023,52(4):691-705.
[8].中华医学会,中华医学会杂志社,中华医学会全科医学分会,等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(实践版·2018) [J] . 中华全科医师杂志,2019,18(1):30-35.
[9].张怡,李璞,陈宝霞.肥胖减重治疗对心血管结局的影响[J].临床内科杂志,2025,42(1):16-19.
[10].Miljkovi? T,Ili? A,Milovan?ev A,et al. Left Atrial strain as a predictor of left ventricular diastolic dysfunction in patients with arterial hypertension[J]. Medicina (Kaunas),2022,58(2):156.
[11].McDonagh TA,Metra M,Adamo M,et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure[J]. Eur Heart J,2021,42(36):3599-3726.
[12].Jeyaprakash P,Moussad A,Pathan S,et al. A systematic review of scaling left atrial size:are alternative indexation methods required for an increasingly obese population?[J]. J Am Soc Echocardiogr,2021,34(10):1067-1076.e3.
[13].O’Neill T,Kang P,Hagendorff A,et al. The clinical applications of left atrial strain:a comprehensive review[J]. Medicina (Kaunas),2024,60(5):693.
[14].Ozkan B,Ndumele CE. Exploring the mechanistic link between obesity and heart failure[J]. Curr Diab Rep,2023,23(12):347-360.
[15].Strzelczyk J,Kalinowski P,Zieniewicz K,et al. The influence of surgical weight reduction on left atrial strain[J]. Obes Surg,2021,31(12):5243-5250.
[16]. Aga YS,Kroon D,Snelder SM,et al. Decreased left atrial function in obesity patients without known cardiovascular disease[J]. Int J Cardiovasc Imaging,2023,39(3):471-479.
[17].Chirinos JA,Sardana M,Satija V,et al. Effect of obesity on left atrial strain in persons aged 35-55 years (The Asklepios Study)[J]. Am J Cardiol,2019,123(5):854-861.
[18].Freed BH,Daruwalla V,Cheng JY,et al. Prognostic utility and clinical significance of cardiac mechanics in heart failure with preserved ejection fraction:importance of left atrial strain[J]. Circ Cardiovasc Imaging,2016,9(3):e003754.
[19].Reddy YNV,Obokata M,Egbe A,et al. Left atrial strain and compliance in the diagnostic evaluation of heart failure with preserved ejection fraction[J]. Eur J Heart Fail.2019,21(7):891-900.
[20].马佳琪,刘轩昌,金冬霞,等. 基于二维斑点追踪超声心动图测定的左心房功能与HFpEF-ABA评分在高血压患者中的相关性研究[J]. 中国心血管杂志,2025,30(2):123-130.
[21].Aminian A,Al-Kurd A,Wilson R,et al. Association of bariatric surgery with major adverse liver and cardiovascular outcomes in patients with biopsy-proven nonalcoholic steatohepatitis[J]. JAMA,2021,326(20):2031-2042.

相似文献/References:

[1]王宏宇.肥胖相关的代谢综合征及其心脏和血管损伤[J].心血管病学进展,2016,(4):331.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.001]
 WANG Hongyu.Obesity-Related Metabolic Syndrome and Its Heart and Vascular Damage[J].Advances in Cardiovascular Diseases,2016,(3):331.[doi:10.16806/j.cnki.issn.1004-3934.2016.04.001]
[2]樊德慧 金娟 韩宇博 田苗 刘莉.利钠肽与代谢综合征的研究进展[J].心血管病学进展,2020,(10):1074.[doi:10.16806/j.cnki.issn.1004-3934.20.10.018]
 FAN Dehui,JIN Juan,HAN Yubo,et al.Research Progress of Natriuretic Peptide and Metabolic Syndrome[J].Advances in Cardiovascular Diseases,2020,(3):1074.[doi:10.16806/j.cnki.issn.1004-3934.20.10.018]
[3]纪欣强 王凡.肥胖悖论与经皮冠状动脉介入治疗预后相关性的研究进展[J].心血管病学进展,2022,(7):615.[doi:10.16806/j.cnki.issn.1004-3934.2022.07.000]
 JI XinqiangWANG Fan.Correlation Between Obesity Paradox and Prognosis of Percutaneous Coronary Intervention[J].Advances in Cardiovascular Diseases,2022,(3):615.[doi:10.16806/j.cnki.issn.1004-3934.2022.07.000]
[4]潘广梅 彭鑫森 刘强 李跃伟 孙明慧 张玉平 吕定超.肥胖症射血分数保留性心力衰竭的炎症机制与治疗进展[J].心血管病学进展,2022,(11):997.[doi:10.16806/j.cnki.issn.1004-3934.2022.11.008]
 PAN Gaungmei,PENG Xinsen,LIU Qiang,et al.Inflammatory Mechanism and Treatment Progress in Obese Phenotype of Heart Failure with Preserved Ejection Fraction[J].Advances in Cardiovascular Diseases,2022,(3):997.[doi:10.16806/j.cnki.issn.1004-3934.2022.11.008]
[5]刘娟婧,杨志明.白脂素对代谢性心血管疾病潜在作用的研究进展[J].心血管病学进展,2023,(8):728.[doi:10.16806/j.cnki.issn.1004-3934.2023.08.013]
 LIU Juanjing,YANG Zhiming.Effect of Asprosin on Metabolic Cardiovascular Disease[J].Advances in Cardiovascular Diseases,2023,(3):728.[doi:10.16806/j.cnki.issn.1004-3934.2023.08.013]

更新日期/Last Update: 2026-07-02