Changes of cardiac structure and function in patients with thoracic lordosis and clinical significance
10.3969/j.issn.1004-406X.2025.06.05
- VernacularTitle:胸椎前凸患者心脏结构和功能的变化及其临床意义
- Author:
Quan LI
1
;
Ying ZHANG
1
;
Kaiwen GU
1
Author Information
1. 昆明医科大学第二附属医院骨科 650033 昆明市
- Publication Type:Journal Article
- Keywords:
Spinal deformity;
Thoracic lordosis;
Cardiac structure;
Cardiac function
- From:
Chinese Journal of Spine and Spinal Cord
2025;35(6):598-605
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To retrospectively analyze the preoperative imaging and echocardiographic data of pa-tients with thoracic lordosis,and to investigate the relationship between thoracic lordosis and the cardiac structure and function by comparing with normal people.Methods:The imaging and echocardiographic data of patients with thoracic lordosis and normal people obtained between January 2013 and December 2023 were collected and analyzed.According to thoracic angle,the patients were divided into group A of 27 cases[tho-racic lordosis(TL)group,T5-T12≤0°]and group B of 29 cases[red uced thoracic kyphotic(TK)group,0°＜T5-T12≤20°].A control group of 29 normal people was set up as group C(normal group,20°＜T5-T 12 ≤ 40°).General clinical data including gender,age,height,weight,body mass index(BMI),body surface area(BSA),imaging parameters on X-ray films such as thoracic sagittal and coronal Cobb angles,imaging findings on CT such as spinal penetration index volume(SPIV)and cardiac volume ratio in apical vertebra region(CVRA)were collected,as well as the echocardiographic parameters including left ventricular end-diastolic diameter(LVDd),right ventricular end-diastolic diameter(RVDd),left atrial diameter(LAD),right atrial diameter(RAD),right ven-tricular outflow tract(RVOT),aortic diameter(AO),ascending aortic diameter(AAO),main pulmonary artery diam-eter(MPA),end-diastolic interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),ejection fraction(EF),fraction shortening(FS),stroke volume(SV),cardiac output(CO),cardiac index(CI),systolic pulmonary artery pressure(SPAP).Statistical analysis was conducted using SPSS 25.0 software for data comparison and correlation analysis between the three groups.Results:SPIV was negatively correlated with sagittal Cobb angle and not correlated with coronal Cobb angle;SPIV was negatively correlated with LVDd,RVDd,LAD,RAD,RVOT,AO,AAO,MPA,IVST,and LVPWT;SPIV wasn't correlated with EF,FS,SV,CO,CI,and SPAP;CVRA was negatively correlated with sagittal Cobb angle and not correlated with coronal Cobb angle;CVRA was negatively correlated with RVDd,IVST,and LVPWT;There was no correla-tion between CVRA and LVDd,LAD,RAD,RVOT,AO,AAO,MPA;CVRA wasn't correlated with EF,FS,SV,CO,CI,and SPAP.Conclusions:SPIV can more effectively reflect the impact of thoracic lordosis on cardiac structure and function than CVRA,and a reduction in thoracic kyphosis angle may exacerbate the workload on cardiac blood vessels.During the orthopedic surgery for patients with thoracic lordosis,significant changes may occur in the structural and functional parameters of the thoracic cavity and cardiac chambers due to factors such as general anesthesia,prone positioning,compression of the sternum and thoracic cage,and muscle relaxant administration,therefore particular attention should be paid to the risks of airway ob-struction and hemodynamic instability.
