Evaluation of the correlation between epicardial adipose tissue thickness and right ventricular function in patients with type 2 diabetes mellitus by two-dimensional speckle tracking
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摘要: 目的:探讨应用二维斑点追踪技术评价2型糖尿病患者右室心肌功能与心外膜脂肪厚度(EAT)的相关性。方法:选取2018年5月-2018年12月我院收治的2型糖尿病患者60例作为糖尿病组,另外选取40例健康志愿者作为对照组,应用二维斑点追踪技术测量心尖四腔切面右室游离壁及室间隔的基底段、中间段、心尖段收缩期各节段纵向应变值,比较2组右室收缩期各节段纵向应变值差异,以及糖尿病组EAT与右室收缩期各节段应变值的相关性。结果:与对照组比较,糖尿病组EAT显著增厚,右室游离壁的基底段、中间段及室间隔的基底段、中间段收缩期纵向应变值减低,差异有统计学意义(P<0.05),右室游离壁及室间隔的心尖段收缩期纵向应变值比较差异无统计学意义(P>0.05)。相关分析显示,糖尿病组EAT与右室游离壁及室间隔的基底段、中间段收缩期纵向应变值负相关,差异有统计学意义(r=-0.53、-0.49、-0.57、-0.59,P<0.05),EAT与低密度脂蛋白(LDL)、BMI呈正相关(r=0.55、0.49,P<0.05)。多元线性回归分析显示,EAT是右室收缩期心肌纵向应变功能的独立影响因素(P<0.05)。结论:2型糖尿病患者右室心肌功能受损,EAT越厚,右室心肌功能受损害更为严重,2型糖尿病患者EAT与右室心肌结构和功能具有密切相关性。Abstract: Objective:The correlation between epicardial adipose tissue(EAT) thickness and right ventricular(RV) systolic function in type-2 diabetes mellitus patients was evaluated by two-dimensional speckle tracking technique.Method:Sixty patients with type 2 diabetes were selected and 40 healthy volunteers were selected as the control group from May 2018 to December 2018 in our hospital.The longitudinal systolic strain values of basal segment(RVFW-bs,RVSW-bs),middle segmen t(RVFW-ms,RVSW-ms),and apical segment(RVFW-as,RVSWas) of the right ventricular free wall and septum wall were measured by two-dimensional speckle tracking technique.The correlation between epicardial adipose tissue thickness and the longitudinal strain of the right ventricular systolic in the two groups was compared.Result:Compared to the control group,the epicardial adipose tissue thickness was significantly thickened in the type-2 diabetes mellitus group(P<0.05).The longitudinal systolic strain of basal segment,middle segment of the right ventricular free wall and septum were decreased(P<0.05).The longitudinal systolic strain of apical segment right ventricular free wall and septum did not change significantly compared with the control group.Correlation analyses showed that EAT thickness was negative correlated with the longitudinal systolic strain values of basal segment,middle segment of the right ventricular free wall,and septum wall,respectively(r=-0.53,-0.49,-0.57,-0.59,P<0.05) and was positively correlated with LDL and BMI(r=0.55,0.49,P<0.05).In multiple linear regression analysis,EAT thickness was independently correlated to the longitudinal strain of the right ventricular systolic.Conclusion:In patients with type 2 diabetes,the myocardial function of the right ventricle is impaired.The thicker of EAT thickness,the more seriously the myocardial function of the right ventricle is impaired.EAT thickness is closely related to the structure and function of the right ventricle in patients with type 2 diabetes.
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