Natale Francesco, Tedesco Michele A, Mocerino Rosa, de Simone Vincenzo, Di Marco Giovanni M, Aronne Luigi, Credendino Maria, Siniscalchi Carmine, Calabrò Paolo, Cotrufo Maurizio, Calabrò Raffaele
Department of Cardiothoracic Sciences, Second University of Naples, Monaldi Hospital, Via L. Bianchi 1, Naples, Italy.
Eur J Echocardiogr. 2009 Jun;10(4):549-55. doi: 10.1093/ejechocard/jep002. Epub 2009 Feb 10.
Relationship between obesity and cardiovascular (CV) disease depends not only on the amount of body fat, but also on its distribution. For example, individuals with increased fat accumulation in the abdominal region have atherogenic lipid profiles and are at increased CV risk. The loss of elasticity in medium and large arteries is an early manifestation of atherosclerosis. The aim of this study was to evaluate whether echocardiographic epicardial adipose tissue, an index of cardiac adiposity, is related to carotid stiffness and carotid intima-media thickness (IMT), indexes of subclinical atherosclerosis, better than waist circumference in hypertensive patients.
We studied 459 patients with Grade I and II essential hypertension who were referred to our outpatient clinic over a period from May 2007 to March 2008. The population was first sorted by waist circumference and then by epicardial fat < or = 7 or >7 mm. We measured epicardial fat thickness, waist circumference, carotid artery stiffness, and carotid IMT in all patients. Patients divided according to waist circumference showed no statistical differences in carotid artery stiffness between the two groups. Subjects with epicardial fat >7 mm were older, had higher systolic, diastolic, and pulse pressure, increased left ventricular mass index, carotid IMT, diastolic parameters, and stiffness parameters compared with those with epicardial fat < or = 7 mm (P < 0.001). A positive correlation was found between epicardial fat and age, pulse pressure, stiffness parameters, carotid IMT, systolic blood pressure, and duration of hypertension, and a negative correlation was found with diastolic parameters. Age, carotid IMT, and stiffness parameters were independently related to epicardial fat.
Our findings indicate that epicardial fat reflects carotid artery stiffness in hypertension-induced organ damage.
肥胖与心血管疾病之间的关系不仅取决于体内脂肪的数量，还取决于其分布情况。例如，腹部脂肪堆积增加的个体具有致动脉粥样硬化的血脂谱，心血管疾病风险增加。中大型动脉弹性丧失是动脉粥样硬化的早期表现。本研究的目的是评估超声心动图测量的心包脂肪组织（一种心脏肥胖指标）与颈动脉僵硬度和颈动脉内膜中层厚度（IMT）（亚临床动脉粥样硬化指标）之间的关系，在高血压患者中，其与这些指标的关系是否优于腰围。
我们研究了2007年5月至2008年3月期间转诊至我们门诊的459例I级和II级原发性高血压患者。首先根据腰围对人群进行分类，然后根据心包脂肪厚度≤7mm或>7mm进行分类。我们测量了所有患者的心包脂肪厚度、腰围、颈动脉僵硬度和颈动脉IMT。根据腰围划分的患者，两组之间颈动脉僵硬度无统计学差异。与心包脂肪厚度≤7mm的受试者相比，心包脂肪厚度>7mm的受试者年龄更大，收缩压、舒张压和脉压更高，左心室质量指数、颈动脉IMT、舒张参数和僵硬度参数增加（P<0.001）。心包脂肪与年龄、脉压、僵硬度参数、颈动脉IMT、收缩压和高血压病程呈正相关，与舒张参数呈负相关。年龄、颈动脉IMT和僵硬度参数与心包脂肪独立相关。
我们的研究结果表明，心包脂肪反映了高血压所致器官损害中的颈动脉僵硬度。
