Willens Howard J, Byers Patricia, Chirinos Julio A, Labrador Eugenio, Hare Joshua M, de Marchena Eduardo
Department of Medicine, Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, USA.
Am J Cardiol. 2007 May 1;99(9):1242-5. doi: 10.1016/j.amjcard.2006.12.042. Epub 2007 Mar 13.
Epicardial fat assessed using echocardiography is associated with abdominal visceral adipose tissue and cardiovascular risk factors. Because of its location, epicardial fat may directly affect the coronary vasculature and myocardium through local secretion of bioactive molecules. This study examines the effects of weight loss after bariatric surgery on epicardial adipose tissue in patients with severe obesity. Clinical data and echocardiograms of 23 patients with severe obesity who had echocardiograms recorded before and 8.3 +/- 3.7 months after undergoing bariatric surgery were retrospectively reviewed. Epicardial fat thickness was measured as the hypoechoic space anterior to the right ventricle in both the parasternal long- and short-axis views, and an average was obtained. At baseline, patients had increased epicardial fat compared with normal-weight controls matched for age, gender, and ethnicity (5.3 +/- 2.4 vs 3.0 +/- 1.1 mm, p <0. 001). Epicardial fat thickness was associated with the patient's initial weight in severely obese patients (r = 0.51, p = 0.011). Patients lost an average of 40 +/- 14 kg after surgery. Epicardial fat thickness decreased from 5.3 +/- 2.4 to 4.0 +/-1.6 mm (p = 0.001). Change in epicardial fat correlated with initial epicardial fat thickness measured using echocardiography (r = 0.71, p <0.001). In conclusion, epicardial fat thickness decreases in severely obese patients who have substantial weight loss after bariatric surgery. Measuring epicardial fat thickness using echocardiography may be useful to monitor visceral fat loss with weight reduction therapies.
使用超声心动图评估的心外膜脂肪与腹部内脏脂肪组织及心血管危险因素相关。由于其位置特殊，心外膜脂肪可能通过局部分泌生物活性分子直接影响冠状动脉血管系统和心肌。本研究探讨了减肥手术后体重减轻对重度肥胖患者心外膜脂肪组织的影响。回顾性分析了23例重度肥胖患者的临床资料和超声心动图，这些患者在接受减肥手术前及术后8.3±3.7个月记录了超声心动图。在心尖四腔心切面和胸骨旁短轴切面上，测量右心室前方的低回声间隙作为心外膜脂肪厚度，并计算平均值。在基线时，与年龄、性别和种族相匹配的正常体重对照组相比，患者的心外膜脂肪增加（5.3±2.4 vs 3.0±1.1 mm，p<0.001）。在重度肥胖患者中，心外膜脂肪厚度与患者的初始体重相关（r=0.51，p=0.011）。患者术后平均体重减轻40±14 kg。心外膜脂肪厚度从5.3±2.4 mm降至4.0±1.6 mm（p=0.001）。心外膜脂肪的变化与超声心动图测量的初始心外膜脂肪厚度相关（r=0.71，p<0.001）。总之，减肥手术后体重显著减轻的重度肥胖患者的心外膜脂肪厚度降低。使用超声心动图测量心外膜脂肪厚度可能有助于监测减重治疗过程中内脏脂肪的减少。
