Ранние электрические и структурные изменения сердца у пациентов без ожирения, страдающих неалкогольной жировой болезнью печени

Цель    Как известно, неалкогольная жировая болезнь печени (НАЖБП) увеличивает риск развития фибрилляции предсердий, не зависимо от наличия и выраженности сопуствующего метаболического синдрома. Целью настоящего исследования явилось изучение влияния НАЖБП на структурные и электрические функции сердца с использованием метода тканевой допплерэхо-кардиографии (ТДЭ) у пациентов без ожирения, страдающих НАЖБП, при от-сутсвии каких-либо известных факторов риска развития ФП.
Материал и методы    В исследование были включены 43 женщины (средний возраст составил 31,3±3,8 года) с гепатостеатозом 2-3 стадии, выявленным при ультразвуковом исследовании печени, диагностированным как НАЖБП без ожирения (исследуемая группа), и 31 здоровая женщина (группа контроля) в возрасте 32,5±3,6 года. В дополнение к стандартным эхокардио-графическим параметрам была исследована внутрипредсердная и межпред-сердная электромеханическая задержка, оцениваемая с помощью ТДЭ.
Результаты    Межпредсердная (различие времени от начала зубца P на поверхностной ЭКГ до начала волны A (PA), зарегистрированного от латерального отдела кольца митрального клапана и кольца трикуспидального клапана), и внутрипредсердная электромеханическая задержка (различие PA от септальной части кольца митрального клапана и кольца трикуспидального клапана) были значительно выше в исследуемой группе пациентов по сравнению с группой здоровых женщин (16,1±3,4 против 12,5±2,3, р <0,001 и 8,4±1,6 против 6,6±1,6, р <0,001, соответственно). Кроме того, размер предсердия, параметры диастолической функции левого желудочка и толщина стенки левого левого желудочка были выше в группе пациентовн с НАЖБП, однако значения указанных показателей находились на субклиническом уровне.
Заключение    В настоящем исследовании межпредсердная и внутрипред-сердная электромеханическая задержка были обнаружены у молодых женщин с НАЖБП без ожирения. Кроме того, на субклиническом уровне были выявлены структурные и функциональные нарушения сердца по данным эхокардиографии. Тем не менее, необходимы большие проспективные исследования для изучения роли этих результатов в развитии ФП у пациентов с НАЖБП без ожирения.

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