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心外膜脂肪厚度与肱动脉血流介导的血管舒张与冠状动脉疾病的关系。

Relation of epicardial fat thickness and brachial flow-mediated vasodilation with coronary artery disease.

机构信息

Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.

Department of Cardiology, Dicle University, Faculty of Medicine, Diyarbakır, Turkey.

出版信息

J Cardiol. 2013 Dec;62(6):343-7. doi: 10.1016/j.jjcc.2013.05.009. Epub 2013 Jul 1.

Abstract

OBJECTIVE

The purpose of this study is to investigate the presence of a statistical association between epicardial fat thickness (EFT) and coronary artery disease (CAD) and between flow-mediated vasodilation (FMD) and CAD.

METHODS

We measured the EFT and FMD in 64 subjects with suspected stable angina pectoris. The patients were separated into two groups according to their coronary angiography results: 34 patients with CAD and 30 patients with normal coronary arteries (NCA).

RESULTS

EFT was significantly higher in the patients with CAD than the NCA group (6.43 ± 0.90 mm vs. 5.35 ± 0.75 mm, p<0.001) while FMD was significantly lower in the patients with CAD than those in the NCA group (6.41 ± 2.51% vs. 8.33 ± 3.45%, p=0.015). No significant correlation was found between EFT and FMD. After adjustment for EFT, FMD, age, sex, ejection fraction, glucose, and low-density lipoprotein cholesterol through multivariate logistic regression analysis, EFT (odds ratio: 6.325, 95% confidence interval 2.289-17.476, p<0.001) and age (odds ratio: 1.093, 95% confidence interval 1.008-1.185, p=0.032) remained significant predictors of CAD. A cut-off value of EFT≥5.8mm predicted the presence of CAD with 77% sensitivity and 70% specificity.

CONCLUSION

An echocardiographic EFT assessment is independently associated with the presence of CAD. Thus, EFT may be helpful in cardiometabolic risk stratification and therapeutic interventions.

摘要

目的

本研究旨在探讨心外膜脂肪厚度(EFT)与冠心病(CAD)之间以及血流介导的血管舒张(FMD)与 CAD 之间是否存在统计学关联。

方法

我们测量了 64 例疑似稳定型心绞痛患者的 EFT 和 FMD。根据冠状动脉造影结果将患者分为两组:34 例 CAD 患者和 30 例正常冠状动脉(NCA)患者。

结果

CAD 组的 EFT 明显高于 NCA 组(6.43±0.90mm 比 5.35±0.75mm,p<0.001),而 CAD 组的 FMD 明显低于 NCA 组(6.41±2.51%比 8.33±3.45%,p=0.015)。EFT 与 FMD 之间未发现显著相关性。通过多元逻辑回归分析,在校正 EFT、FMD、年龄、性别、射血分数、血糖和低密度脂蛋白胆固醇后,EFT(比值比:6.325,95%置信区间 2.289-17.476,p<0.001)和年龄(比值比:1.093,95%置信区间 1.008-1.185,p=0.032)仍然是 CAD 的显著预测因素。EFT≥5.8mm 的截断值预测 CAD 的存在,其敏感性为 77%,特异性为 70%。

结论

超声心动图 EFT 评估与 CAD 的存在独立相关。因此,EFT 可能有助于心血管代谢风险分层和治疗干预。

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