과체중 및 비만 환자에서 좌심실 기능의 조기 변화: 티슈 도플러 심초음파를 이용한 분석 (The Early Change of Left Ventricular Function in Overweight and Obese Patients: Analysis With Tissue Doppler Echocardiography)

서지정보

· 발행기관 : 대한심장학회
· 수록지 정보 : Korean Circulation Journal / 38권 / 5호 / 270 ~ 275페이지
· 저자명 : 유승기, 최재웅, 조용범

초록

Background and Objectives: Obesity is a cause of cardiac dysfunction. We analyzed the change of diastolic function
with the increase of the body mass index (BMI) for the early detection of cardiac dysfunction in overweight
and obese patients. To analyze the diastolic function, we measured the mitral valve early and late diastolic inflow
velocities with performing Doppler studies (E, A) and the early and late mitral annulus velocities with performing
tissue Doppler studies (E’, A’). Subjects and Methods: From January 2005 to October 2007, 2,684 cases
were enrolled in this study. The patients had a normal cardiac size, normal systolic function, no regional wall
motion abnormalities and no significant valve disease. Those patients with a history of congenital heart disease,
renal failure and congestive heart failure were excluded. The BMI was checked and Doppler echocardiographic
analysis, including tissue Doppler, was done. Results: The left ventricle (LV) mass index (normal: 89.1±19.1,
overweight: 95.7±18.4, obese: 97.2±18.9 g/m2, p<0.01), and the E/E’ (8.84±2.81, 10.02±3.03, 10.84±3.66,
respectively, p<0.01) were higher, and the E (72.4±16.7, 68.6±16.0, 71.5±17.0 cm/sec, respectively, p<0.01),
and E’ (8.78±2.77, 7.27±2.19, 7.17±2.62 cm/sec, respectively, p<0.01) were lower in the overweight (BMI≥25
kg/m2) and obese groups (BMI≥30 kg/m2) than that of the normal group. On multiple logistic regression analysis,
overweight was an independent risk factor for diastolic dysfunction with considering other risk factors such
as hypertension, diabetes mellitus, age and gender. The risk of LV diastolic dysfunction was increased 2.13 times
in the overweight group and 3.1 times in the obese group as compared with the normal group. Conclusion: With
an increase of weight, diastolic function was worsened before the development of systolic dysfunction. This change
was apparent in the overweight group. Tissue Doppler study on the mitral annulus is more sensitive to detect the
change of diastolic function in overweight and obese patients.

영어초록

Background and Objectives: Obesity is a cause of cardiac dysfunction. We analyzed the change of diastolic function
with the increase of the body mass index (BMI) for the early detection of cardiac dysfunction in overweight
and obese patients. To analyze the diastolic function, we measured the mitral valve early and late diastolic inflow
velocities with performing Doppler studies (E, A) and the early and late mitral annulus velocities with performing
tissue Doppler studies (E’, A’). Subjects and Methods: From January 2005 to October 2007, 2,684 cases
were enrolled in this study. The patients had a normal cardiac size, normal systolic function, no regional wall
motion abnormalities and no significant valve disease. Those patients with a history of congenital heart disease,
renal failure and congestive heart failure were excluded. The BMI was checked and Doppler echocardiographic
analysis, including tissue Doppler, was done. Results: The left ventricle (LV) mass index (normal: 89.1±19.1,
overweight: 95.7±18.4, obese: 97.2±18.9 g/m2, p<0.01), and the E/E’ (8.84±2.81, 10.02±3.03, 10.84±3.66,
respectively, p<0.01) were higher, and the E (72.4±16.7, 68.6±16.0, 71.5±17.0 cm/sec, respectively, p<0.01),
and E’ (8.78±2.77, 7.27±2.19, 7.17±2.62 cm/sec, respectively, p<0.01) were lower in the overweight (BMI≥25
kg/m2) and obese groups (BMI≥30 kg/m2) than that of the normal group. On multiple logistic regression analysis,
overweight was an independent risk factor for diastolic dysfunction with considering other risk factors such
as hypertension, diabetes mellitus, age and gender. The risk of LV diastolic dysfunction was increased 2.13 times
in the overweight group and 3.1 times in the obese group as compared with the normal group. Conclusion: With
an increase of weight, diastolic function was worsened before the development of systolic dysfunction. This change
was apparent in the overweight group. Tissue Doppler study on the mitral annulus is more sensitive to detect the
change of diastolic function in overweight and obese patients.

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