怀孕期间的肥胖是产后期持续的亚临床心肌功能障碍的预测因素
Andrea Sonaglioni1,2, Gian Luigi Nicolosi3, Stefano Bianchi4
1Department of Cardiology, Ospedale San Giuseppe MultiMedica IRCCS, Via San Vittore 12, 20123, Milano, Italy. sonaglioniandrea@gmail.com.
The international journal of cardiovascular imaging
|September 19, 2023
概括
肥胖的孕妇面临着患产后持续的亚临床心肌功能障碍的更高风险. 先进的孕产妇年龄,更高的BMI和高的中性粒细胞与淋巴细胞比率 (NLR) 是关键预测因素.
科学领域:
- 心脏病学 心脏病学
- 产科 产科 产科 产科 产科
- 孕产妇健康 孕产妇健康
背景情况:
- 怀孕期间的肥胖会给心血管系统带来独特的挑战.
- 之前的研究缺乏在这个人群中全面的功能性心脏评估.
- 与肥胖相关的心血管变化对母亲的结果的影响仍然不清楚.
研究的目的:
- 在肥胖的孕妇中对所有心室进行完整的功能评估.
- 为了澄清在怀孕期间因肥胖引起的心血管变化和母亲的结果之间的关联.
- 评估产后持续的亚临床心肌功能障碍的风险.
主要方法:
- 研究了一组46名肥胖的孕妇 (BMI≥30Kg/m2) 和83名对照.
- 在第一个和第三个三个月和产后进行了2D斑点跟踪的胸前回声心脏成像.
- 分析了心肌变形指数,包括左心室全球纵向应变 (LV-GLS).
主要成果:
- 肥胖的孕妇表现出明显较低的心肌应变指数,尽管正常的双心室缩功能.
- 持续的亚临床心肌功能障碍 (LV-GLS <-20%) 在86.9%的产后肥胖妇女中被观察到.
- 母亲年龄 (≥35岁),第三个月的BMI (≥30Kg/m2) 和NLR (≥5.5) 独立预测了这一结果.
结论:
- 肥胖的孕妇,特别是35岁以上的孕妇,患有持续性亚临床心肌功能障碍的风险较高.
- 第三季度的BMI和中性粒细胞与淋巴细胞的比率是预测产后心脏功能障碍的关键指标.
- 早期识别和监测对于管理肥胖孕妇心血管风险至关重要.
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