在慢血流现象患者中，心外膜脂肪组织增加。

Increased epicardial adipose tissue in patients with slow coronary flow phenomenon.

机构信息

Department of Cardiology, Rize University Medical Faculty, Rize, Turkey.

出版信息

Kardiol Pol. 2012;70(9):903-9.

Abstract

BACKGROUND

Slow coronary flow (SCF) is an angiographic finding characterised by delayed opacification of epicardial coronary arteries without obstructive coronary disease. Epicardial adipose tissue (EAT), localised beneath the visceral pericardium, is a metabolically active endocrine and paracrine organ with possible interactions within the heart. EAT and low-grade inflammation play major roles in the atherosclerotic vascular processes and may be important in other coronary pathologies such as SCF.

AIM

To investigate whether EAT and C-reactive protein (CRP) are increased in patients with isolated SCF compared to normal subjects.

METHODS

The present study was cross-sectional and observational, consisting of 66 individuals who underwent coronary angiography with a suspicion of coronary artery disease and who had angiographically normal coronary arteries of varying coronary flow rates. The relationship between EAT, CRP and SCF phenomenon was investigated. Thirty-three patients with isolated SCF (mean age: 56 ± 10 years) and 33 age- and gender-matched control participants with normal coronary flow (NCF), but without SCF, (mean age: 55 ± 10 years) were included in the study.

RESULTS

EAT thickness was significantly increased in the SCF group compared to the NCF group (7.1 ± 2.7 vs. 4.7 ± 1.9 mm, p < 0.001). Body mass index (BMI, p < 0.001) and the percentage of isolated SCF (p = 0.002) were significantly higher in patients with increased EAT thickness. CRP was not related to SCF. When we performed multiple logistic regression analysis, only increased EAT thickness was related to the presence of SCF (OR 1.720, 95% CI 1.175-2.516, p = 0.005) independent of BMI and CRP.

CONCLUSIONS

This study revealed, for the first time, a significant increase in EAT thickness in patients with SCF compared to NCF. We believe that further studies are needed to clarify the role of adipose tissue in patients with SCF.

摘要

背景

慢血流（SCF）是一种冠状动脉造影表现，其特征为心外膜冠状动脉显影延迟，而无阻塞性冠状动脉疾病。心外膜脂肪组织（EAT）位于脏层心包下，是一种代谢活跃的内分泌和旁分泌器官，可能与心脏内的其他组织相互作用。EAT 和低度炎症在动脉粥样硬化血管过程中起主要作用，并且在其他冠状动脉病变（如 SCF）中可能很重要。

目的

研究与正常对照相比，孤立性 SCF 患者的 EAT 和 C 反应蛋白（CRP）是否增加。

方法

本研究为横断面和观察性研究，共纳入 66 例因疑似冠状动脉疾病而行冠状动脉造影检查的患者，这些患者的冠状动脉血管造影正常，但冠状动脉血流速度不同。研究了 EAT、CRP 与 SCF 现象之间的关系。纳入 33 例孤立性 SCF 患者（平均年龄：56±10 岁）和 33 例年龄和性别匹配的正常冠状动脉血流（NCF）但无 SCF 的对照患者（平均年龄：55±10 岁）。

结果

与 NCF 组相比，SCF 组的 EAT 厚度显著增加（7.1±2.7 vs. 4.7±1.9 mm，p<0.001）。EAT 厚度增加患者的体质量指数（BMI，p<0.001）和孤立性 SCF 百分比（p=0.002）显著更高。CRP 与 SCF 无关。当我们进行多变量逻辑回归分析时，只有 EAT 厚度增加与 SCF 的存在相关（OR 1.720，95%CI 1.175-2.516，p=0.005），独立于 BMI 和 CRP。