Erdoğan Turan, Çetin Mustafa, Kocaman Sinan Altan, Durakoğlugil Murtaza Emre, Ergül Elif, Uğurlu Yavuz, Çanga Altun
Department of Cardiology, Faculty of Medicine, Rize University, Rize-Turkey.
Anadolu Kardiyol Derg. 2013 Jun;13(4):320-7. doi: 10.5152/akd.2013.099. Epub 2013 Mar 26.
Epicardial adipose tissue (EAT) secretes various inflammatory mediators and growth factor, and has endocrine and paracrine effects on myocardium and body. We planned the present study in order to evaluate the possible relationship between EAT and left ventricular mass (LVM), a potent predictor of cardiovascular mortality and morbidity, independent of age, blood pressure and the metabolic parameters in patients with hypertension (HT).
The present study was cross-sectional and observational, including consecutive 107 untreated essential hypertensive patients who underwent a complete transthoracic echocardiographic examination as well as measurements of LVM and EAT. Blood pressure, routine blood chemistry, C-reactive protein, and patient characteristics were also recorded. Univariate and then multiple linear regression analyses were used for analysis of independent variables associated with EAT.
LVM significantly correlated with waist circumference, EAT, glucose, uric acid, high-density lipoprotein (HDL) cholesterol, and systolic and diastolic blood pressure. When we divided study population into two groups according to median mean blood pressure (BP) (Mean BP ≤116 vs. >116 mmHg), EAT was the only associated factor for LVM in patients below median BP (Beta: 0.518, p<0.001). Linear regression analyses revealed EAT to be independently associated with LVM (Beta: 0.419; p<0.001) and LVM index (Beta: 0.384, p<0.001) as well as high-density lipoprotein (Beta: -0.264, p=0.006).
EAT was related to increased LVM independent of BMI, waist circumference, weight, systolic and diastolic blood pressure and other risk parameters, in patients with HT. Determination of increased EAT by echocardiography may have an additional value as an indicator of cardiovascular risk and total visceral adipose tissue.
心外膜脂肪组织（EAT）分泌多种炎症介质和生长因子，对心肌和身体具有内分泌和旁分泌作用。我们开展本研究以评估EAT与左心室质量（LVM）之间的可能关系，LVM是心血管死亡率和发病率的有力预测指标，独立于高血压（HT）患者的年龄、血压和代谢参数。
本研究为横断面观察性研究，纳入连续107例未经治疗的原发性高血压患者，这些患者接受了完整的经胸超声心动图检查以及LVM和EAT测量。还记录了血压、常规血液生化、C反应蛋白和患者特征。采用单变量分析，然后进行多线性回归分析来分析与EAT相关的独立变量。
LVM与腰围、EAT、血糖、尿酸、高密度脂蛋白（HDL）胆固醇以及收缩压和舒张压显著相关。当我们根据平均血压中位数（BP）（平均BP≤116 vs.>116 mmHg）将研究人群分为两组时，EAT是血压中位数以下患者LVM的唯一相关因素（β：0.518，p<0.001）。线性回归分析显示EAT与LVM（β：0.419；p<0.001）、LVM指数（β：0.384，p<0.001）以及高密度脂蛋白（β：-0.264，p=0.006）独立相关。
在HT患者中，EAT与LVM增加相关，独立于BMI、腰围、体重、收缩压和舒张压以及其他风险参数。通过超声心动图测定EAT增加可能作为心血管风险和总内脏脂肪组织指标具有额外价值。
