Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Republic of Korea.
Int J Cardiol. 2013 Sep 1;167(5):2234-8. doi: 10.1016/j.ijcard.2012.06.013. Epub 2012 Jun 21.
Epicardial adipose tissue represents visceral adiposity, the early detection of which could be helpful for assessing subclinical target organ damage. Although previous studies have reported a relationship between epicardial fat thickness (EFT) and carotid intima-media thickness, there have been no studies detailing the relationship between EFT and brachial-ankle pulse wave velocity (baPWV).
We consecutively enrolled 655 subjects (445 men, 55 ± 9 years) who underwent echocardiography and baPWV and had an ankle-brachial index greater than 0.95. The subjects were divided into four quartile groups depending on EFT. Subjects were also classified into two groups according to baPWV: group I (324 subjects), baPWV ≤ 1366 cm/s, and group II (331 subjects), baPWV>1366 cm/s.
The EFT in group II was significantly higher than in group I (4.2mm vs. 3.7 mm, p<0.001). There were significant differences in baPWV values among the EFT quartile groups (quartile I, 1327 ± 148.8 cm/s; quartile II, 1371 ± 215.0 cm/s; quartile III, 1434 ± 228.3 cm/s; quartile IV, 1507 ± 233.1 cm/s; p-value<0.001). In multivariate regression models, the highest quartile groups of EFT had higher odds ratios (ORs) for increased baPWV compared with that of the lowest quartile group (OR [95% confidence interval (CI)]: 2.19[1.21-3.95]), irrespective of confounding factors. Moreover, EFT was an independent determinant of baPWV (standard β=0.113, p=0.001).
This study demonstrates an independent relationship between EFT and arterial stiffness, suggesting that echocardiographic EFT measurement could be an easy-to-measure tool for early detection of subclinical target organ damage.
心外膜脂肪组织代表内脏肥胖，早期检测有助于评估亚临床靶器官损害。尽管先前的研究报告了心外膜脂肪厚度（EFT）与颈动脉内膜中层厚度之间的关系，但尚无研究详细描述 EFT 与臂踝脉搏波速度（baPWV）之间的关系。
我们连续纳入了 655 名接受超声心动图和 baPWV 检查且踝臂指数大于 0.95 的患者。根据 EFT 将患者分为四组。根据 baPWV 将患者分为两组：I 组（324 例），baPWV≤1366cm/s；II 组（331 例），baPWV>1366cm/s。
II 组的 EFT 明显高于 I 组（4.2mm 比 3.7mm，p<0.001）。EFT 四分位组之间的 baPWV 值存在显著差异（四分位 I：1327±148.8cm/s；四分位 II：1371±215.0cm/s；四分位 III：1434±228.3cm/s；四分位 IV：1507±233.1cm/s；p 值<0.001）。在多变量回归模型中，与最低四分位组相比，EFT 最高四分位组的 baPWV 比值更高（比值比[95%置信区间（CI）]：2.19[1.21-3.95]），无论混杂因素如何。此外，EFT 是 baPWV 的独立决定因素（标准β=0.113，p=0.001）。
本研究表明 EFT 与动脉僵硬度之间存在独立关系，提示超声心动图 EFT 测量可能是早期检测亚临床靶器官损害的一种简便工具。
