Department of Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
J Geriatr Cardiol. 2013 Mar;10(1):10-5. doi: 10.3969/j.issn.1671-5411.2013.01.003.
Coronary artery ectasia (CAE) refers to abnormal dilation of coronary artery segments to 1.5 times of adjacent normal ones. Epicardial fat is associated with cardiovascular risk factors. The relationship between CAE and epicardial fat has not yet been investigated. This study aimed to assess the relationship between CAE and epicardial fat volume (EFV) in older people by dual-source computed tomography coronary angiography (CTCA).
We prospectively enrolled 1400 older adults who were scheduled for dual-source CTCA. Under reconstruction protocols, patients with abnormal segments 1.5 times larger than the adjacent segments were accepted as CAE. EFV was measured by semi-automated software. Traditional risk factors in CAE patients, as well as the extent of EFV, were analyzed and compared to non-CAE group.
A total of 885 male and 515 female older patients were enrolled. CAE was identified by univariable analysis in 131 patients and significantly correlated to hypertension, smoking, hyperlipidemia, prior percutaneous coronary intervention and ascending aorta aneurysm. EFV was shown to be significantly higher in CAE patients than patients without ectasia. In multivariable analyses, EFV (P = 0.018), hypertension (P < 0.001) and hyperlipidemia (P < 0.001) were significantly correlated to CAE. There was a significant negative correlation between EFV and Markis classification.
CAE can be reliably recognized by dual-source CTCA. Epicardial fat might play a role in etiopathogenesis and progression of CAE, providing a new target for treating ectasia.
冠状动脉扩张（CAE）是指冠状动脉节段异常扩张至相邻正常节段的 1.5 倍。心外膜脂肪与心血管危险因素有关。CAE 与心外膜脂肪之间的关系尚未得到研究。本研究旨在通过双源 CTCA 评估老年人 CAE 与心外膜脂肪体积（EFV）之间的关系。
我们前瞻性纳入了 1400 名计划行双源 CTCA 的老年人。根据重建方案，将异常节段大于相邻节段 1.5 倍的患者视为 CAE。EFV 通过半自动软件进行测量。分析并比较 CAE 患者的传统危险因素和 EFV 程度与非 CAE 组。
共纳入 131 名男性和 515 名女性老年人。单变量分析发现 131 名患者存在 CAE，且与高血压、吸烟、高血脂、既往经皮冠状动脉介入治疗和升主动脉瘤显著相关。CAE 患者的 EFV 明显高于无扩张患者。多变量分析显示，EFV（P = 0.018）、高血压（P < 0.001）和高血脂（P < 0.001）与 CAE 显著相关。EFV 与 Markis 分类呈显著负相关。
双源 CTCA 可可靠地识别 CAE。心外膜脂肪可能在心外膜扩张的发病机制和进展中起作用，为治疗扩张提供了新的靶点。
