超声心动图显示的心外膜脂肪厚度增加和高敏C反应蛋白水平升高表明新诊断的原发性高血压患者存在舒张功能障碍。

Increased echocardiographic epicardial fat thickness and high-sensitivity CRP level indicate diastolic dysfunction in patients with newly diagnosed essential hypertension.

作者信息

Turak Osman, Özcan Firat, Canpolat Uğur, Işleyen Ahmet, Cebeci Muhammet, Öksüz Fatih, Mendi Mehmet A, Çağli Kumral, Gölbaşi Zehra, Aydoğdu Sinan

机构信息

Department of Cardiology, Türkiye Yüksek Ihtisas Education and Research Hospital, Ankara, Turkey.

出版信息

Blood Press Monit. 2013 Oct;18(5):259-64. doi: 10.1097/MBP.0b013e3283651d19.

DOI:10.1097/MBP.0b013e3283651d19

PMID:23949417

Abstract

BACKGROUND

Hypertension (HT) is one of the main conditions associated with left ventricular (LV) diastolic dysfunction. Epicardial fat tissue (EFT) serves as a source of a plenty of proinflammatory cytokines and is associated with increased cardiovascular events. The aim of the current study was to evaluate the relation among echocardiographically measured EFT thickness, systemic inflammation, and LV diastolic dysfunction in patients with essential HT.

PATIENTS AND METHODS

The study included 135 newly diagnosed and untreated hypertensive outpatients. On the basis of conventional Doppler and tissue Doppler imaging-derived parameters, patients were divided into two groups: 60 patients with normal diastolic function and 75 patients with LV diastolic dysfunction. EFT thickness was measured from the parasternal long-axis view at end-systole and high-sensitivity C-reactive protein (hs-CRP) was assessed using the latex-enhanced immunoturbidimetric method.

RESULTS

In patients with LV diastolic dysfunction, EFT thickness was significantly increased compared with the normal diastolic function group (7.9 ± 1.7 vs. 6.3 ± 1.5 mm; P < 0.001, respectively). Serum hs-CRP level was also significantly higher in the LV diastolic dysfunction group (P < 0.001) and was correlated with EFT thickness (r = 0.442, P < 0.001). In stepwise multivariate logistic regression analysis, EFT thickness (odds ratio 1.27, 95% confidence interval 1.12-1.43; P = 0.006) and hs-CRP level (odds ratio 1.42, 95% confidence interval 1.18-1.72; P = 0.003) emerged as independent positive predictors of LV diastolic dysfunction.

CONCLUSION

In patients with newly diagnosed and untreated essential HT, increased EFT thickness and hs-CRP level are significantly related to impaired LV diastolic function independent from other factors, including age, waist circumference, and 24-h systolic blood pressure.

摘要

背景

高血压（HT）是与左心室（LV）舒张功能障碍相关的主要病症之一。心外膜脂肪组织（EFT）是多种促炎细胞因子的来源，并且与心血管事件增加有关。本研究的目的是评估原发性高血压患者经超声心动图测量的EFT厚度、全身炎症与LV舒张功能障碍之间的关系。

患者和方法

该研究纳入了135例新诊断且未接受治疗的高血压门诊患者。根据传统多普勒和组织多普勒成像得出的参数，将患者分为两组：60例舒张功能正常的患者和75例LV舒张功能障碍的患者。在收缩末期从胸骨旁长轴视图测量EFT厚度，并使用乳胶增强免疫比浊法评估高敏C反应蛋白（hs-CRP）。

结果

与舒张功能正常组相比，LV舒张功能障碍患者的EFT厚度显著增加（分别为7.9±1.7 vs. 6.3±1.5mm；P<0.001）。LV舒张功能障碍组的血清hs-CRP水平也显著更高（P<0.001），并且与EFT厚度相关（r=0.442，P<0.001）。在逐步多因素逻辑回归分析中，EFT厚度（比值比1.27，95%置信区间1.12-1.43；P=0.006）和hs-CRP水平（比值比1.42，95%置信区间1.18-1.72；P=0.003）成为LV舒张功能障碍的独立阳性预测因素。