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Tác động của thừa cân đến chức năng tâm thất trái trong bệnh tiểu đường loại 2
Tóm tắt
Sự đồng tồn tại của suy chức năng co bóp cơ tâm thất trái theo chiều dọc với suy chức năng tâm trương tâm thất trái có thể dẫn đến suy tim với phân suất tống máu bảo tồn (HFpEF). Tiểu đường (DM) được biết đến như một yếu tố quan trọng liên quan đến HFpEF. Mặc dù cơ chế gây tổn thương cơ tim tâm thất trái liên quan đến DM là phức tạp, nhưng đã được giả thiết rằng thừa cân góp phần vào sự phát triển tổn thương cơ tim tâm thất trái ở bệnh nhân mắc tiểu đường loại 2 (T2DM). Tuy nhiên, ảnh hưởng chính xác của thừa cân đến chức năng co bóp cơ tâm thất trái theo chiều dọc ở bệnh nhân T2DM vẫn chưa được làm rõ. Chúng tôi đã nghiên cứu 145 bệnh nhân T2DM không triệu chứng có phân suất tống máu tâm thất trái (LVEF) bảo tồn mà không có bệnh động mạch vành. Chức năng co bóp cơ tâm thất trái theo chiều dọc được đánh giá bằng biến dạng theo chiều dọc toàn cầu (GLS), được định nghĩa là giá trị trung bình đỉnh của 18 đoạn lấy từ các góc nhìn chóp tiêu chuẩn. Thừa cân được định nghĩa là chỉ số khối cơ thể (BMI) ≥ 25 kg/m2. Chín mươi tình nguyện viên khỏe mạnh được ghép cặp về tuổi, giới và LVEF đã được sử dụng làm đối chứng. GLS của bệnh nhân T2DM thừa cân thấp hơn đáng kể so với bệnh nhân không thừa cân (17,9 ± 2,4% so với 18,9 ± 2,6%, p < 0,05), trong khi đó GLS của cả nhóm đối chứng thừa cân và không thừa cân tương tự nhau (19,8 ± 1,3% so với 20,4 ± 2,1%, p = 0,38). Hơn nữa, phân tích hồi quy đa biến đã chỉ ra rằng đối với bệnh nhân T2DM, BMI là yếu tố xác định độc lập cho GLS cũng như chỉ số khối lượng tâm thất trái. Thừa cân có tác động lớn hơn đến chức năng co bóp cơ tâm thất trái theo chiều dọc ở bệnh nhân T2DM so với những người khỏe mạnh không bị DM. Phát hiện của chúng tôi càng gợi ý rằng việc kiểm soát chặt chẽ tình trạng thừa cân ở bệnh nhân T2DM có thể liên quan đến việc ngăn ngừa sự phát triển của HFpEF.
Từ khóa
#tiểu đường #thừa cân #chức năng tâm thất trái #suy tim #biến dạng theo chiều dọc toàn cầuTài liệu tham khảo
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