孤立性冠状动脉扩张患者的心外膜脂肪组织增加。

Increased epicardial adipose tissue in patients with isolated coronary artery ectasia.

作者信息

Çetin Mustafa, Erdoğan Turan, Kocaman Sinan Altan, Çanga Aytun, Çiçek Yüksel, Durakoğlugil Murtaza Emre, Şatıroğlu Ömer, Akgül Özgür, Bostan Mehmet

机构信息

Department of Cardiology, Rize Education and Research Hospital, Turkey.

出版信息

Intern Med. 2012;51(8):833-8. doi: 10.2169/internalmedicine.51.7121. Epub 2012 Apr 15.

DOI:10.2169/internalmedicine.51.7121

PMID:22504235

Abstract

BACKGROUND

Epicardial adipose tissue (EAT), localized beneath the visceral pericardium, is a metabolically active endocrine and paracrine organ with possible interactions within the heart. Coronary artery ectasia (CAE) is a clinical entity characterized with localized or diffuse dilatation, of the coronary arteries, with a diameter of greater than 1.5 times that of adjacent segments. Although the etiopathogenesis is not clearly understood, some studies have revealed that CAE may be a form of atherosclerosis that has greater inflammatory properties than atherosclerosis. The goal of this study was to investigate whether EAT and the level of C-reactive protein (CRP) are increased in patients with isolated CAE compared to normal subjects.

METHODS

Thirty-three patients with isolated CAE (mean age: 57±9 years) and 32 age- and gender-matched control participants with NCA, but without CAE (mean age: 56±10 years), were included in the study. The relationship between EAT thickness, CRP levels and the presence of CAE was investigated.

RESULTS

Epicardial adipose tissue thickness was significantly higher in CAE group compared to NCA group (7.2±3.2 vs. 4.7±2.1 mm, p<0.001). Body mass index (BMI, p=0.013), CRP (p=0.047), and the percentage of isolated CAE (p=0.012) were significantly higher in patients with an increased EAT thickness. While CRP correlated with increased EAT, it was not related to CAE. However, CRP levels were higher in patients with diffuse coronary ectatic involvement than the focal lesions (0.58±0.32 vs. 0.31±0.11 mg/dL, p=0.046). When we performed multiple logistic regression analysis, only increased EAT thickness was related to CAE independent of CRP and BMI (OR: 1.442, 95%CI: 1.066-1.951, p=0.018).

CONCLUSION

This is the first study, displaying a significantly higher EAT-thickness in patients with isolated CAE. We believe that further studies are needed to clarify the role of adipose tissue in patients with isolated CAE.

摘要

背景

心外膜脂肪组织（EAT）位于脏层心包下方，是一个具有代谢活性的内分泌和旁分泌器官，可能与心脏存在相互作用。冠状动脉扩张（CAE）是一种临床病症，其特征为冠状动脉局部或弥漫性扩张，直径大于相邻节段的1.5倍。尽管其发病机制尚不清楚，但一些研究表明，CAE可能是动脉粥样硬化的一种形式，具有比动脉粥样硬化更强的炎症特性。本研究的目的是调查与正常受试者相比，孤立性CAE患者的心外膜脂肪组织（EAT）和C反应蛋白（CRP）水平是否升高。

方法

本研究纳入了33例孤立性CAE患者（平均年龄：57±9岁）和32例年龄和性别匹配的无CAE的非冠状动脉疾病（NCA）对照参与者（平均年龄：56±10岁）。研究了EAT厚度、CRP水平与CAE存在之间的关系。

结果

与NCA组相比，CAE组的心外膜脂肪组织厚度显著更高（7.2±3.2 vs. 4.7±2.1 mm，p<0.001）。EAT厚度增加的患者体重指数（BMI，p=0.013）、CRP（p=0.047）和孤立性CAE的百分比（p=0.012）显著更高。虽然CRP与EAT增加相关，但与CAE无关。然而，弥漫性冠状动脉扩张累及患者的CRP水平高于局灶性病变患者（0.58±0.32 vs. 0.31±0.11 mg/dL，p=0.046）。当我们进行多因素逻辑回归分析时，仅EAT厚度增加与CAE相关，独立于CRP和BMI（比值比：1.442，95%置信区间：1.066-1.951，p=0.018）。