功能、形态和临床参数对冠心病患者心外膜脂肪组织的影响。
Impact of functional, morphological and clinical parameters on epicardial adipose tissue in patients with coronary artery disease.
机构信息
1st Department of Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
出版信息
Circ J. 2012;76(10):2426-34. doi: 10.1253/circj.cj-12-0301. Epub 2012 Jul 13.
BACKGROUND
Because a close relationship between epicardial adipose tissue (EAT) and coronary artery disease (CAD) has been shown, the impact of functional, morphological and clinical parameters to identify potential determinants of EAT was investigated.
METHODS AND RESULTS
Clinical and cardiac magnetic resonance parameters were determined and correlated to the amount of EAT in 158 patients with CAD and 40 healthy subjects. Patients with CAD and left ventricular function (LVEF) ≥50% revealed significantly elevated EAT (36±11g/m²) compared to healthy controls (31±8g/m²) and to patients with LVEF <50% (26±8.0g/m²). In the whole study population, only LVEF (P=0.003), body mass index (BMI) (P=0.004) and left ventricular end diastolic diameter (LV-EDD) (P=0.004) remained significantly associated with EAT after multivariate analysis. Subgroup analysis in patients with CAD and LVEF ≥50% showed that BMI (P=0.03) was the only correlate of EAT. However, in patients with CAD and LVEF <50%, indexed LV end diastolic mass (LV-EDMI) (P=0.003) and the extent of late gadolinium enhancement (LGE %) (P=0.03) remained significantly correlated with EAT in multivariate analysis.
CONCLUSIONS
The amount and the determinants of EAT differ according to the LVEF in patients with CAD. Thus, different amounts of EAT reflect different stages of CAD underlining the complex interaction of EAT in the pathogenesis and progression of ischemic cardiomyopathy.
背景
已经表明心外膜脂肪组织（EAT）与冠状动脉疾病（CAD）之间存在密切关系，因此研究了功能、形态和临床参数对确定 EAT 潜在决定因素的影响。
方法和结果
在 158 例 CAD 患者和 40 例健康对照者中，确定了临床和心脏磁共振参数，并将其与 EAT 的量相关联。与健康对照组（31±8g/m²）和左心室射血分数（LVEF）<50%的患者（26±8g/m²）相比，CAD 患者和 LVEF≥50%的患者的 EAT 明显升高（36±11g/m²）。在整个研究人群中，只有 LVEF（P=0.003）、体重指数（BMI）（P=0.004）和左心室舒张末期直径（LV-EDD）（P=0.004）在多变量分析后仍与 EAT 显著相关。在 CAD 患者和 LVEF≥50%的亚组分析中，BMI（P=0.03）是唯一与 EAT 相关的因素。然而，在 CAD 患者和 LVEF<50%的患者中，LV 舒张末期质量指数（LV-EDMI）（P=0.003）和晚期钆增强（LGE%）（P=0.03）在多变量分析中与 EAT 仍显著相关。
结论
在 CAD 患者中，EAT 的量和决定因素因 LVEF 而异。因此，不同量的 EAT 反映了 CAD 的不同阶段，突出了 EAT 在缺血性心肌病发病机制和进展中的复杂相互作用。
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