medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2021-14-158-162medsovet-6444Research ArticleПРАКТИКАPRACTICEТолщина желудочков и межжелудочковой перегородки у мужчин с избыточной массой тела по данным эхокардиографииThe thickness of the ventricles and interventricular septum in males with overweight according to echocardiographyhttps://orcid.org/0000-0003-3738-0281МартиросянЛ. П.MartirosyanL. P.

Мартиросян Лусине Пилосовна, ассистент кафедры нормальной, топографической и клинической анатомии, оперативной хирургии

614990, Пермь, ул. Петропавловская, д. 26

Lusine P. Martirosyan, Assistant of the Department of Normal, Topographic and Clinical Anatomy, Operative Surgery

26, Petropavlovskaya St., Perm, 614990

lusindamart@list.ruhttps://orcid.org/0000-0002-4856-9066БаландинаИ. А.BalandinaI. A.

Баландина Ирина Анатольевна, д.м.н., профессор, заведующая кафедрой нормальной, топографической и клинической анатомии, оперативной хирургии

614990, Пермь, ул. Петропавловская, д. 26

Irina A. Balandina, Dr. Sci. (Med.), Professor, Head of the Department of Normal, Topographic and Clinical Anatomy, Operative Surgery

26, Petropavlovskaya St., Perm, 614990

balandina_ia@mail.ruПермский государственный медицинский университет имени академика Е.А. ВагнераРоссияVagner Perm State Medical UniversityRussian Federation202118102021014158162Copyright © Мартиросян Л.П., Баландина И.А., 20212021Мартиросян Л.П., Баландина И.А.Martirosyan L.P., Balandina I.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/6444

Введение. Смертность от сердечно-сосудистых заболеваний занимает первое место в мире. Необходимы новые и высокие требования по анатомическому обоснованию появляющихся методов и приемов лечения. В современной литературе присутствует достаточно много публикаций, касающихся вопросов морфологии сердца, но данные относительно влияния половой принадлежности, возраста, массы тела на параметры сердца недостаточны, отрывочны и часто противоречивы.Цель. Определение толщины желудочков и межжелудочковой перегородки у мужчин с избыточной массой тела при выполнении эхокардиографии и оценка наличия или отсутствия взаимосвязи этих параметров с возрастом и индексом массы тела обследуемых.Материалы и методы. Проведен анализ протоколов ультразвукового исследования сердца 68 условно здоровых мужчин юношеского возраста, первого и второго периодов зрелого возраста с индексом массы тела 25,0–29,9 кг/м², с отсутствием легочной и сердечной патологии и рисков сердечно-сосудистых заболеваний. Ультразвуковое исследование проведено на ультразвуковом сканере Aloka ProSound Alpha 6.Результаты и обсуждение. При сравнении средних значений параметров сердца у мужчин с избыточной массой тела в трех возрастных группах по критерию Краскелла – Уоллиса статистически достоверных различий между средними значениями не выявлено (р > 0,05). При определении корреляционной зависимости параметров сердца от возраста и массы тела выявлена умеренной силы взаимосвязь толщины передней стенки правого желудочка с возрастом обследуемого (r = 0,375; р = 0,020) и умеренной силы взаимосвязь толщины задней стенки левого желудочка с ИМТ (r = 0,352; р = 0,030).Выводы. Результаты исследования дополняют имеющиеся в научной литературе сведения о толщине желудочков сердца и межжелудочковой перегородки у здоровых мужчин с избыточной массой тела в трех возрастных группах. Полученные данные будут полезны врачам функциональной диагностики при проведении эхокардиографии в вопросах разграничения нормы и патологии.

Introduction. Mortality from cardiovascular disease ranks first in the world. New and high requirements are required for the anatomical substantiation of emerging methods and methods of treatment. In modern literature, there are many publications on the issues of heart morphology, but data on the influence of gender, age, body weight on heart parameters are insufficient, fragmentary and often contradictory.Objective. To determine the thickness of the ventricles and interventricular septum in overweight men when performing echocardiography and to assess the presence or absence of the relationship of these parameters with age and body mass index (BMI) of the subjects. Patients and methods. The analysis of the protocols of ultrasound examination of the heart of 68 apparently healthy men of adolescence, the first and second periods of adulthood with a body mass index of 25.0–29.9 kg/m², with no pulmonary and cardiac pathology and the risk of cardiovascular diseases was carried out. Ultrasound examination was performed on an Aloka ProSound Alpha 6 ultrasound scanner. Results and discussion. When comparing the mean values of heart parameters in overweight men in three age groups according to the Kruskell – Wallis criterion, no statistically significant differences were found between the mean values (p > 0.05). Revealed a moderate strength relationship between the thickness of the anterior wall of the right ventricle with the age of the subject (r = 0.375; p = 0.020) and moderate strength relationship between the thickness of the posterior wall of the left ventricle and BMI (r = 0.352; p = 0.030).Conclusions. The  results of  the  study supplement the  information available in  the  scientific literature on the  thickness of  the  ventricles of  the  heart and the  interventricular septum in  healthy men with overweight in  three age groups. The data obtained will be useful to doctors of functional diagnostics when performing echocardiography in matters of differentiation between norm and pathology.

эхокардиографияжелудочки сердцамежжелудочковая перегородкаморфометрияизбыточная масса телаechocardiographyheart ventriclesinterventricular septummorphometryoverweightReferencesОганов Р.Г., Масленникова Г.Я. Профилактика сердечно-сосудистых и других неинфекционных заболеваний – основа улучшения демографической ситуации в России. Кардиоваскулярная терапия и профилактика. 2005;4(3):4–9. Режим доступа: https://cardiovascular.elpub.ru/jour/article/view/961/612.Oganov R.G., Maslennikova G.Y. Prevention of cardiovascular and other non-communicable diseases – a basis for Russian demographic situation improvement. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2005;4(3):4–9. (In Russ.) Available at: https://cardiovascular.elpub.ru/jour/article/view/961/612.Leon L.J., Gustafsson A.B. Staying young at heart: autophagy and adaptation to cardiac aging. J Mol Cell Cardiol. 2016;95:78–85. https://doi.org/10.1016/j.yjmcc.2015.11.006.Leon L.J., Gustafsson A.B. Staying young at heart: autophagy and adaptation to cardiac aging. J Mol Cell Cardiol. 2016;95:78–85. https://doi.org/10.1016/j.yjmcc.2015.11.006.Таратухин Е.О., Нестеров С.С. Сердечно-сосудистая смерть с правовой и этикомедицинской точек зрения: проблема терминологии. Кардиоваскулярная терапия и профилактика. 2019;18(5):98–101. https://doi.org/10.15829/1728-8800-2019-5-98-101.Taratukhin E.O., Nesterov S.S. Cardiovascular death from legal and medical ethics viewpoint: a terminology problem. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2019;18(5):98–101. (In Russ.) https://doi.org/10.15829/1728-8800-2019-5-98-101.Васильев Д.К., Руденко Б.А. Современные аспекты реваскуляризации миокарда при хронических окклюзиях коронарного русла. Кардиоваскулярная терапия и профилактика. 2019;18(6):69–74. https://doi.org/10.15829/1728-8800-2019-6-69-74.Vasiliev D.K., Rudenko B.A. Modern considerations of myocardial revascularization in coronary chronic total occlusion. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2019;18(6):69–74. (In Russ.) https://doi.org/10.15829/1728-8800-2019-6-69-74.Cullen J.H.S., Horsfield M.A., Reek C.R., Cherryman G.R., Barnett D.B., Samani N.J. A myocardial perfusion reserve index in humans using firstpass contrast-enhanced magnetic resonance imaging. J Am Coll Cardiol. 1999;33(5):1386–1394. https://doi.org/10.1016/S0735-1097(99)00004-2.Cullen J.H.S., Horsfield M.A., Reek C.R., Cherryman G.R., Barnett D.B., Samani N.J. A myocardial perfusion reserve index in humans using firstpass contrast-enhanced magnetic resonance imaging. J Am Coll Cardiol. 1999;33(5):1386–1394. https://doi.org/10.1016/S0735-1097(99)00004-2.Khanna R., Cullen H.C. Coronary artery surgery with induced temporary asystole and intermittent ventricular pacing: an experimental study. Cardiovasc Surg. 1996;4(2):231–236. https://doi.org/10.1016/0967-2109(96)82322-2.Khanna R., Cullen H.C. Coronary artery surgery with induced temporary asystole and intermittent ventricular pacing: an experimental study. Cardiovasc Surg. 1996;4(2):231–236. https://doi.org/10.1016/0967-2109(96)82322-2.Skallerud B., Prot V., Notdrum I.S. Modeling active muscle contraction in mitral valve leaflets during systole: a first approach. Biomech Model Mechanobiol. 2011;10(1):11–26. https://doi.org/10.1007/s10237-010-0215-9.Skallerud B., Prot V., Notdrum I.S. Modeling active muscle contraction in mitral valve leaflets during systole: a first approach. Biomech Model Mechanobiol. 2011;10(1):11–26. https://doi.org/10.1007/s10237-010-0215-9.Seko Y., Kato T., Morita Y., Yamaji Y., Haruna Y., Izumi T. et al. Age- and Body Size-Adjusted Left Ventricular End-Diastolic Dimension in a Japanese Hospital-Based Population. Circ J. 2019;83(3):604–613. https://doi.org/10.1253/circj.CJ-18-1095.Seko Y., Kato T., Morita Y., Yamaji Y., Haruna Y., Izumi T. et al. Age- and Body Size-Adjusted Left Ventricular End-Diastolic Dimension in a Japanese Hospital-Based Population. Circ J. 2019;83(3):604–613. https://doi.org/10.1253/circj.CJ-18-1095.Shirakabe A., Ikeda Y., Sciarretta S., Zablocki D.K., Sadoshima J. Aging and Autophagy in the Heart. Circ Res. 2016;118(10):1563–1576. https://doi.org/10.1161/CIRCRESAHA.116.307474.Shirakabe A., Ikeda Y., Sciarretta S., Zablocki D.K., Sadoshima J. Aging and Autophagy in the Heart. Circ Res. 2016;118(10):1563–1576. https://doi.org/10.1161/CIRCRESAHA.116.307474.Dai D., Chen T., Johnson S.C., Szeto H., Rabinovitch P.S. Cardiac Aging: From Molecular Mechanisms to Significance in Human Health and Disease. Antioxid Redox Signal. 2012;16(12):1492–1526. https://doi.org/10.1089/ars.2011.4179.Dai D., Chen T., Johnson S.C., Szeto H., Rabinovitch P.S. Cardiac Aging: From Molecular Mechanisms to Significance in Human Health and Disease. Antioxid Redox Signal. 2012;16(12):1492–1526. https://doi.org/10.1089/ars.2011.4179.Costantino S., Paneni F., Cosentino F. Ageing, metabolism and cardiovascular disease. J Physiol. 2016;594(8):2061–2073. https://doi.org/10.1113/JP270538.Costantino S., Paneni F., Cosentino F. Ageing, metabolism and cardiovascular disease. J Physiol. 2016;594(8):2061–2073. https://doi.org/10.1113/JP270538.Crea F., Battipaglia I., Andreotti F. Sex differences in mechanisms, presentation and management of ischaemic heart disease. Atherosclerosis. 2015;241(1):157–168. https://doi.org/10.1016/j.atherosclerosis.2015.04.802.Crea F., Battipaglia I., Andreotti F. Sex differences in mechanisms, presentation and management of ischaemic heart disease. Atherosclerosis. 2015;241(1):157–168. https://doi.org/10.1016/j.atherosclerosis.2015.04.802.Kane A.E., Howlett S.E. Differences in Cardiovascular Aging in Men and Women. Adv Exp Med Biol. 2018;1065:389–411. https://doi.org/10.1007/978-3-319-77932-4_25.Kane A.E., Howlett S.E. Differences in Cardiovascular Aging in Men and Women. Adv Exp Med Biol. 2018;1065:389–411. https://doi.org/10.1007/978-3-319-77932-4_25.Keller K.M., Howlett S.E. Sex Differences in the Biology and Pathology of the Aging Heart. Can J Cardiol. 2016;32(9):1065–1073. https://doi.org/10.1016/j.cjca.2016.03.017.Keller K.M., Howlett S.E. Sex Differences in the Biology and Pathology of the Aging Heart. Can J Cardiol. 2016;32(9):1065–1073. https://doi.org/10.1016/j.cjca.2016.03.017.Гнатюк М.С. О морфометрии нормального сердца. Судебно-медицинская экспертиза. 1978;(3):18–20. Режим доступа: https://www.forens-med.ru/book.php?id=3949.Gnatyuk M.S. About morphometry of a normal heart. Sudebnomeditsinskaya ekspertisa = Forensic Medical Expertise. 1978;(3):18–20. (In Russ.) Available at: https://www.forens-med.ru/book.php?id=3949.Dzeshka M.S., Shahid F., Shantsila A., Lip G.Y.H. Hypertension and Atrial Fibrillation: An Intimate Association of Epidemiology, Pathophysiology, and Outcomes. Am J Hypertens. 2017;30(8):733–755. https://doi.org/10.1093/ajh/hpx013.Dzeshka M.S., Shahid F., Shantsila A., Lip G.Y.H. Hypertension and Atrial Fibrillation: An Intimate Association of Epidemiology, Pathophysiology, and Outcomes. Am J Hypertens. 2017;30(8):733–755. https://doi.org/10.1093/ajh/hpx013.Velagaleti R.S., Gona P., Pencina M.J., Aragam J., Wang T.G., Levy D. et al. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 2014;113(1):117–122. https://doi.org/10.1016/j.amjcard.2013.09.028.Velagaleti R.S., Gona P., Pencina M.J., Aragam J., Wang T.G., Levy D. et al. Left ventricular hypertrophy patterns and incidence of heart failure with preserved versus reduced ejection fraction. Am J Cardiol. 2014;113(1):117—122. https://doi.org/10.1016/j.amjcard.2013.09.028.Heinzel F.R., Hohendanner F., Jin G., Sedej S., Edelmann F. Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. J Appl Physiol. 2015;119(10):1233–1242. https://doi.org/10.1152/japplphysiol.00374.2015.Heinzel F.R., Hohendanner F., Jin G., Sedej S., Edelmann F. Myocardial hypertrophy and its role in heart failure with preserved ejection fraction. J Appl Physiol. 2015;119(10):1233–1242. https://doi.org/10.1152/japplphysiol.00374.2015.Wang W., James C.A., Calkins H. Diagnostic and therapeutic strategies for arrhythmogenic right ventricular dysplasia/cardiomyopathy patient. EP Europace. 2019;21(1):9–21. https://doi.org/10.1093/europace/euy063.Wang W., James C.A., Calkins H. Diagnostic and therapeutic strategies for arrhythmogenic right ventricular dysplasia/cardiomyopathy patient. EP Europace. 2019;21(1):9–21. https://doi.org/10.1093/europace/euy063.Corrado D., Wichter T., Link M.S., Hauer R.N.W., Marchlinski F.E., Anastasakis A. et al. Treatment of Arrhythmogenic Right Ventricular Cardiomyopathy/ Dysplasia: An International Task Force Consensus Statement. Circulation. 2015;132(5):441–453. https://doi.org/10.1161/CIRCULATIONAHA.115.017944.Corrado D., Wichter T., Link M.S., Hauer R.N.W., Marchlinski F.E., Anastasakis A. et al. Treatment of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia: An International Task Force Consensus Statement. Circulation. 2015;132(5):441–453. https://doi.org/10.1161/CIRCULATIONAHA.115.017944.Appleton C.P., Galloway J.M., Gonzalez M.S., Gaballa M., Basnight M.A. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction. J Am Coll Cardiol. 1993;22(7):1972—1982. https://doi.org/10.1016/0735-1097(93)90787-2.Appleton C.P., Galloway J.M., Gonzalez M.S., Gaballa M., Basnight M.A. Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease. Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contraction. J Am Coll Cardiol. 1993;22(7):1972—1982. https://doi.org/10.1016/0735-1097(93)90787-2.Barve R.A., Gu C.C., Yang W., Chu J., Dávila-Román V.G., Fuentes L. Genetic association of left ventricular mass assessed by M-mode and two-dimensional echocardiography. J Hypertens. 2016;34(1):88–96. https://doi.org/10.1097/HJH.0000000000000765.Barve R.A., Gu C.C., Yang W., Chu J., Dávila-Román V.G., Fuentes L. Genetic association of left ventricular mass assessed by M-mode and two-dimensional echocardiography. J Hypertens. 2016;34(1):88–96. https://doi.org/10.1097/HJH.0000000000000765.Nagre A.S. Focus-assessed transthoracic echocardiography: Implications in perioperative and intensive care. Ann Card Anaesth. 2019;22(3):302–308. https://doi.org/10.4103/aca.ACA_88_18.Nagre A.S. Focus-assessed transthoracic echocardiography: Implications in perioperative and intensive care. Ann Card Anaesth. 2019;22(3):302–308. https://doi.org/10.4103/aca.ACA_88_18.Strait J.B., Lakatta E.G. Aging-associated cardiovascular changes and their relationship to heart failure. Heart Fail Clin. 2012;8(1):143–164. https://doi.org/10.1016/j.hfc.2011.08.011.Strait J.B., Lakatta E.G. Aging-associated cardiovascular changes and their relationship to heart failure. Heart Fail Clin. 2012;8(1):143–164. https://doi.org/10.1016/j.hfc.2011.08.011.Самусев Р.П., Зубарева Е.В., Рудаскова Е.С., Адельшина Г.А. Прижизненные изменения некоторых структурных показателей левого желудочка сердца в возрастном аспекте. Вестник Волгоградского государственного медицинского университета. 2016;1(57):97–99. Режим доступа: https://vestnik.volgmed.ru/ru/article/2633.Samusev R.P., Zubareva E.V., Rudaskova E.S., Adel’shina G.A. Lifetime changes in some structural parameters of the left ventricle of the heart in the age aspect. Vestnik Volgogradskogo gosudarstvennogo meditsinskogo universiteta = Journal of Volgograd State Medical University. 2016;1(57):97–99. (In Russ.) Available at: https://vestnik.volgmed.ru/ru/article/2633.Zangana S.N., Faeq A.K., Al-Bustani D.A. Effects of body mass index on left ventricular function and structure among a sample of apparently healthy adults in Erbil city-Iraq. Intern J Mult Res Rev. 2016;1(18):147–152. Available at: https://www.ijmdrr.com/admin/downloads/1710201630.pdfZangana S.N., Faeq A.K., Al-Bustani D.A. Effects of body mass index on left ventricular function and structure among a sample of apparently healthy adults in Erbil city-Iraq. Intern J Mult Res Rev. 2016;1(18):147–152. Available at: https://www.ijmdrr.com/admin/downloads/1710201630.pdf.Wong L.S.M., van der Harst P., de Boer R.A., Huzen J., van Gilst W.H., van Veldhuisen D.J. Aging, telomeres and heart failure. Heart Fail Rev. 2010;15(5):479–486. https://doi.org/10.1007/s10741-010-9173-7.Wong L.S.M., van der Harst P., de Boer R.A., Huzen J., van Gilst W.H., van Veldhuisen D.J. Aging, telomeres and heart failure. Heart Fail Rev. 2010;15(5):479–486. https://doi.org/10.1007/s10741-010-9173-7.Horn M.A., Graham H.K., Richards M.A., Clarke J.D., Greensmith D.J., Briston S.J. et al. Age-related divergent remodeling of the cardiac extracellular matrix in heart failure: collagen accumulation in the young and loss in the aged. J Mol Cell Cardiol. 2012;53(1):82–90. https://doi.org/10.1016/j.yjmcc.2012.03.011.Horn M.A., Graham H.K., Richards M.A., Clarke J.D., Greensmith D.J., Briston S.J. et al. Age-related divergent remodeling of the cardiac extracellular matrix in heart failure: collagen accumulation in the young and loss in the aged. J Mol Cell Cardiol. 2012;53(1):82–90. https://doi.org/10.1016/j.yjmcc.2012.03.011.Merz A.A., Cheng S. Sex differences in cardiovascular ageing. Heart. 2016;102(11):825–831. https://doi.org/10.1136/heartjnl-2015-308769.Merz A.A., Cheng S. Sex differences in cardiovascular ageing. Heart. 2016;102(11):825–831. https://doi.org/10.1136/heartjnl-2015-308769.Nanayakkara S., Marwick T.H., Kaye D.M. The ageing heart: the systemic and coronary circulation. Heart. 2018;104(5):370—376. https://doi.org/10.1136/heartjnl-2017-312114.Nanayakkara S., Marwick T.H., Kaye D.M. The ageing heart: the systemic and coronary circulation. Heart. 2018;104(5):370—376. https://doi.org/10.1136/heartjnl-2017-312114.Souza Angelo L.C., Campos Vieira M.L., Rodrigues S.L., Morelato R.L., Pereira A.C., Mill J.G., Krieger J.E. Echocardiographic Reference Values an a Sample of Asymptomatic Adult Brazilian Population. Arq Bras Cardiol. 2007;89(3):168–173. https://doi.org/10.1590/s0066-782x2007001500007.Souza Angelo L.C., Campos Vieira M.L., Rodrigues S.L., Morelato R.L., Pereira A.C., Mill J.G., Krieger J.E. Echocardiographic Reference Values an a Sample of Asymptomatic Adult Brazilian Population. Arq Bras Cardiol. 2007;89(3):168–173. https://doi.org/10.1590/s0066-782x2007001500007..7868/S2587667821010088.0. Drapkina O.M., Livzan M.A., Martynov A.I., Moiseev S.V., Nikolaev N.A., Skirdenko Yu.P. The first Russian consensus on quantifying adherence to treatment: basic provisions, algorithms and recommendations. Meditsinskiy vestnik Severnogo Kavkaza = Medical News of the North Caucasus. 2018;13(1–2): 259–271. (In Russ.) https://doi.org/10.14300/mnnc.2018.13039.

The authors declare that there are no conflicts of interest present.