超声心动图评估肥胖儿童和青少年亚临床心肌功能障碍的研究进展

doi:10.3969/j.issn.1004-583X.2026.08.015

摘要/Abstract

摘要：

肥胖是全球儿童和青少年面临的重大健康挑战之一,不仅导致代谢紊乱还显著影响心血管系统。多项证据表明,肥胖儿童在尚未出现明显临床症状时,其心脏结构和功能已悄然发生亚临床改变,这可能预示着有发生远期心血管疾病的风险。传统超声心动图参数对早期心肌功能变化的敏感性有限,近年来,新兴的超声技术,如斑点追踪成像、心肌做功及心脏-动脉耦联等技术,为早期精准识别肥胖相关心脏损害提供了有力手段。本文系统综述了超声心动图技术在评估肥胖儿童青少年亚临床心肌功能障碍中的研究进展,重点阐述其核心参数的临床意义,旨在为早期干预和风险管理提供理论指导。

关键词: 超声心动描记术, 斑点追踪成像技术, 心脏-动脉耦联, 心脏病危险因素, 儿童肥胖

中图分类号:

R542.2

张然, 洪林巍. 超声心动图评估肥胖儿童和青少年亚临床心肌功能障碍的研究进展[J]. 临床荟萃, 2026, 41(8): 759-762.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.08.015

https://www.lchc.cn/CN/Y2026/V41/I8/759

参考文献 41

[1]	Ren J, Wu NN, Wang S, et al. Obesity cardiomyopathy:evidence, mechanisms, and therapeutic implications[J]. Physiol Rev, 2021, 101(4):1745-1807.doi:10.1152/physrev.00030.2020.
[2]	Šileikienė R, Adamonytė K, Ziutelienė A, et al. Atrial and ventricular structural and functional alterations in obese children[J]. Medicina (Kaunas), 2021, 57(6):562.doi:10.3390/medicina57060562.
[3]	Bartkowiak J, Spitzer E, Kurmann R, et al. The impact of obesity on left ventricular hypertrophy and diastolic dysfunction in children and adolescents[J]. Sci Rep, 2021, 11(1):13022.doi:10.1038/s41598-021-92463-x. pmid: 34158575
[4]	Koopman LP, Mertens LL. Impact of childhood obesity on cardiac structure and function[J]. Curr Treat Options Cardiovasc Med, 2014, 16(11):345.doi:10.1007/s11936-014-0345-y. pmid: 25193558
[5]	Tang Y, Yang GB, Chen J, et al. Association between left ventricular remodeling and lipid profiles in obese children: An observational study[J]. Front Pediatr, 2024, 12:1308887.doi:10.3389/fped.2024.1308887.
[6]	Larios G, Uribe S, Trincado C, et al. Myocardial function, mechanics and work by echocardiography in adolescents with severe obesity[J]. Cardiovasc Endocrinol Metab, 2024, 13(2):e0301.doi:10.1097/XCE.0000000000000301.
[7]	Siurana JM, Ventura PS, Yeste D, et al. Myocardial geometry and dysfunction in morbidly obese adolescents (BMI 35-40 kg/m²)[J]. Am J Cardiol, 2021, 157:128-134.doi:10.1016/j.amjcard.2021.07.026. pmid: 34392890
[8]	Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines[J]. Circulation, 2022, 145(18):e895-e1032.doi:10.1161/CIR.0000000000001063. pmid: 35363499
[9]	Saltijeral A, Perez de Isla L. Obese children and myocardial deformation changes: Some discrepancies but a large number of common points[J]. Eur Heart J Cardiovasc Imaging, 2014, 15(4):473.doi:10.1093/ehjci/jet264. pmid: 24375564
[10]	段洪梅, 张铁山, 范梅贞, 等. 定量组织速度成像和组织追踪成像评价肥胖儿童左心功能[J]. 中国妇幼保健, 2009, 24(9):1218-1220.
[11]	Ghandi Y, Sharifi M, Habibi D, et al. Evaluation of left ventricular function in obese children without hypertension by a tissue Doppler imaging study[J]. Ann Pediatr Cardiol, 2018, 11(1):28-33.doi:10.4103/apc.APC_75_17. pmid: 29440827
[12]	李梅, 张晓蓉, 薛爱玲. 超声心动图检测单纯性肥胖儿童心脏功能的改变[J]. 中国临床医生, 2014, 42(7):79-81.
[13]	王丽丽. 超声心动图评估单纯肥胖对青年人右心结构及功能的影响[D]. 南昌: 南昌大学, 2014.
[14]	陈琳, 申凯凯, 张喜君, 等. 超声心肌应变评价心肌炎左心心肌损伤的研究进展[J/OL]. 中华医学超声杂志(电子版), 2024, 21(12):1154-1157.doi:10.3877/cma.j.issn.1672-6448.2024.12.010.
[15]	周贵明, 牛晓娜. 超声心动图评估单纯肥胖儿童左心室功能的改变[J/OL]. 中华临床医师杂志(电子版), 2016, 10(22):3334-3336.
[16]	郭振伟, 郭文彬, 朱梅, 等. 应变率成像评价单纯性肥胖儿童左室局部心肌的收缩功能[J]. 医学影像学杂志, 2008, (5):478-480.
[17]	Faggiano A, Gherbesi E, Sala C, et al. Targeting Myocardial mechanics in children and adolescents with obesity and non-elevated blood pressure: A meta-regression study[J]. Diseases, 2025, 13(9):301.doi:10.3390/diseases13090301.
[18]	Dehghan B, Sedighi M, Rostampour N, et al. Childhood obesity is associated with subclinical left ventricular dysfunction detected by speckle tracking echocardiography[J]. Clin Pediatr (Phila), 2024, 63(7):936-941.doi:10.1177/00099228231201203.
[19]	Hurtado-Sierra D, Colin-Ramírez E, Lena-Hernández EL, et al. Subclinical cardiac alterations detected by echocardiography in Mexican schoolchildren with overweight and obesity[J]. Arch Cardiol Mex, 2019, 89(3):222-232.doi:10.24875/ACM.M19000040. pmid: 31588144
[20]	Kibar AE, Pac FA, İbrahim E, et al. Effect of obesity on left ventricular longitudinal myocardial strain by speckle tracking echocardiography in children and adolescents[J]. Balkan Med J, 2015, 32(1):56-63.doi:10.5152/balkanmedj.2015.15136. pmid: 25759773
[21]	邓艺雯, 章春泉, 许燕, 等. 三维斑点追踪技术评估单纯性肥胖儿童左室心肌应变早期变化[J]. 中国超声医学杂志, 2018, 34(3):217-220.
[22]	Paysal J, Merlin E, Rochette E, et al. Left atrial remodeling in adolescents with obesity evaluated by speckle-tracking echocardiography[J]. Int J Obes (Lond), 2024, 48(1):111-117.doi:10.1038/s41366-023-01397-z.
[23]	Steele JM, Urbina EM, Mazur WM, et al. Left atrial strain and diastolic function abnormalities in obese and type 2 diabetic adolescents and young adults[J]. Cardiovasc Diabetol, 2020, 19(1):163.doi:10.1186/s12933-020-01139-9. pmid: 33004030
[24]	Geng J, Zhang X, Guo Y, et al. Moderate-intensity interval exercise exacerbates cardiac lipotoxicity in high-fat, high-calories diet-fed mice[J]. Nat Commun, 2025, 16(1):613.doi:10.1038/s41467-025-55917-8.
[25]	Ananda RA, Solomon B, Ray KK. Individual and joint associations of obesity and metabolic health parameters on arterial stiffness: Evidence from the UK Biobank[J]. Diabetes Obes Metab, 2025, 27(2):899-910.doi:10.1111/dom.16090. pmid: 39587367
[26]	罗宇琦, 王洋洋, 林洁, 等. 心力衰竭中的肥胖悖论最新研究进展[J]. 临床心血管病杂志, 2024, 40(10):804-810.doi:10.13201/j.issn.1001-1439.2024.10.006.
[27]	Chen CH, Nakayama M, Nevo E, et al. Coupled systolic-ventricular and vascular stiffening with age: Implications for pressure regulation and cardiac reserve in the elderly[J]. J Am Coll Cardiol, 1998, 32(5):1221-1227.doi:10.1016/s0735-1097(98)00374-x. pmid: 9809929
[28]	Koopman LP, McCrindle BW, Slorach C, et al. Interaction between myocardial and vascular changes in obese children: A pilot study[J]. J Am Soc Echocardiogr, 2012, 25(4):401-410.e1.doi:10.1016/j.echo.2011.12.018.
[29]	Chirinos JA, Rietzschel ER, De Buyzere ML, et al. Arterial load and ventricular-arterial coupling: Physiologic relations with body size and effect of obesity[J]. Hypertension, 2009, 54:558-566.doi:10.1161/HYPERTENSIONAHA.109.131870. pmid: 19581507
[30]	Russell K, Eriksen M, Aaberge L, et al. A novel clinical method for quantification of regional left ventricular pressure-strain loop area: A non-invasive index of myocardial work[J]. Eur Heart J, 2012, 33(6):724-733.doi:10.1093/eurheartj/ehs016. pmid: 22315346
[31]	Huang J, Li GA, Wang J, et al. Evaluation of subclinical left ventricular systolic dysfunction in obese patients by global myocardial work[J]. Diabetol Metab Syndr, 2023, 15(1):254.doi:10.1186/s13098-023-01230-7. pmid: 38057836
[32]	Paysal J, Merlin E, Rochette E, et al. Global and regional myocardial work in female adolescents with weight disorders[J]. J Clin Med, 2021, 10(20):4671.doi:10.3390/jcm10204671.
[33]	Tran AH, Walsh A, Urbina EM. Hypertension, obesity, and target organ injury in children: An emerging health care crisis[J]. Curr Hypertens Rep, 2025, 27(1):12.doi:10.1007/s11906-025-01329-4. pmid: 40014185
[34]	Corica D, Oreto L, Pepe G, et al. Precocious preclinical cardiovascular sonographic markers in metabolically healthy and unhealthy childhood obesity[J]. Front Endocrinol (Lausanne), 2020, 11:56.doi:10.3389/fendo.2020.00056.
[35]	Cote AT, Phillips AA, Harris KC, et al. Obesity and arterial stiffness in children: Systematic review and meta-analysis[J]. Arterioscler Thromb Vasc Biol, 2015, 35(4):1038-1044.doi:10.1161/ATVBAHA.114.305062. pmid: 25633314
[36]	周丽, 王淑霞, 王芳, 等. 三维斑点追踪成像技术对单纯性肥胖儿童左心室收缩功能的评价及其与外周动脉弹性相关性的前瞻性研究[J]. 中国当代儿科杂志, 2022, 24(5):566-571.
[37]	许燕, 章春泉, 邓艺雯, 等. 三维斑点追踪技术评价肥胖儿童左室心肌应变及其与C反应蛋白相关性研究[J]. 中国超声医学杂志, 2018, 34(10):888-891.
[38]	Holmstrøm V, Smistad E, Stølen S, et al. Real-time global longitudinal strain during echocardiography: A deep learning platform for improved workflow[J]. J Am Soc Echocardiogr, 2025, 38(11):1041-1051.doi:10.1016/j.echo.2025.08.015.
[39]	Sveric KM, Botan R, Winkler A, et al. The role of artificial intelligence in standardizing global longitudinal strain measurements in echocardiography[J]. Eur Heart J Imaging Methods Pract, 2024, 2(4):qyae130.doi:10.1093/ehjimp/qyae130.
[40]	Parizad R, Hatwal J, Brar A, et al. Artificial intelligence for cardiovascular risk prediction: An umbrella review of applications and translational challenges[J]. Vasc Health Risk Manag, 2026, 22:590502.doi:10.2147/VHRM.S590502.
[41]	Huang H, Wu RS, Lin M, et al. Emerging wearable ultrasound technology[J]. IEEE Trans Ultrason Ferroelectr Freq Control, 2024, 71(7):713-729.doi:10.1109/TUFFC.2023.3327143.

超声心动图评估肥胖儿童和青少年亚临床心肌功能障碍的研究进展

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献 41

相关文章 15

编辑推荐

Metrics

本文评价

[1]	高玉叶, 徐海, 孙妍. 肥胖对呼吸功能的影响及机制[J]. 临床荟萃, 2023, 38(4): 381-384.
[2]	赵子琪, 白璐, 韩若凌. 胸部恶性肿瘤患者放射性心脏损伤特征及超声心动图评估价值[J]. 临床荟萃, 2022, 37(4): 373-378.
[3]	李志勇, 李星, 何真. 肾动脉小慢波频谱联合超声心动图对成人型主动脉缩窄的临床价值[J]. 临床荟萃, 2021, 36(8): 739-743.
[4]	马惠，张永峰，李慧莉，冯国燕. 实时三维超声及组织速度向量评价肺动脉高压患者右心室收缩功能及相关性研究[J]. 临床荟萃, 2018, 33(6): 506-509,514.
[5]	魏孟严，郑明奇. 致心律失常性右心室心肌病临床表现与诊断[J]. 临床荟萃, 2017, 32(7): 565-570.
[6]	杨瑛，智光. 超声心动图在化疗监测中的应用[J]. 临床荟萃, 2017, 32(4): 365-368.
[7]	汪雁博;谷新顺;郝国贞;李伟;邢坤;耿巍;傅向华. 急性ST段抬高心肌梗死合并肺动脉高压患者院内主要心脏不良事件分析[J]. 临床荟萃, 2015, 30(7): 751-754.
[8]	巩雷;刁军;李勇;郝骥;冯建启;彭城;祁春梅. 多巴酚丁胺负荷超声下斑点追踪与组织多普勒技术检测存活心肌的临床价值[J]. 临床荟萃, 2015, 30(7): 765-768.
[9]	魏小红;商鸿;张庆华;周丽珠;雷小亭;周朝晖. 二维斑点追踪技术对H型及非H型原发性高血压患者心脏机能的对比研究[J]. 临床荟萃, 2015, 30(6): 617-620.
[10]	王婧;柳达;罗文利;高银凤. 老年心力衰竭患者同型半胱氨酸和胱抑素C水平及意义[J]. 临床荟萃, 2015, 30(3): 265-267.
[11]	姚丽;张力;吕旺;李永星;胡亚民. 芪苈强心胶囊治疗慢性心力衰竭合并心律失常83例疗效[J]. 临床荟萃, 2014, 29(9): 968-971.
[12]	窦蕊;冯荣光;杨鹏;武仁;刘炯鸥;栗平;郭志英;牛云枫. 超声心动图评价高血压左心室舒张功能变化及其与血清脂联素和可溶性细胞黏附分子1的相关性[J]. 临床荟萃, 2014, 29(9): 978-981.
[13]	齐恩林;马星;刘文瑞;平泽;吴南;刘书海. 实时双平面超声在诊断胎儿单纯室间隔缺损中的应用[J]. 临床荟萃, 2014, 29(8): 944-945.
[14]	高亚坤;张玉辉;刘颖;李丽. 实时三维超声心动图对前降支不同程度狭窄患者心功能的评价[J]. 临床荟萃, 2014, 29(8): 946-947962.
[15]	张宁;孔雁;姚铁柱;郑金秀;刘宇;孙芳毅;冯和林. 应用蒽环类药物化疗患者血清瘦素、N-端脑钠肽前体与超声心动图的变化[J]. 临床荟萃, 2014, 29(6): 689-691.