Atakan Aydin, Macunluoglu Beyza, Kaya Yuksel, Ari Elif, Demir Halit, Asicioglu Ebru, Kaspar Cigdem
Department of Nephrology, Fatih Sultan Mehmet State Hospital, Istanbul, Turkey.
Hemodial Int. 2014 Jan;18(1):62-9. doi: 10.1111/hdi.12091. Epub 2013 Sep 4.
Cardiovascular disease (CVD) is the main cause of mortality in hemodialysis (HD) patients. Epicardial fat tissue (EFT) is a new risk factor in CVD. The aim of this study was to evaluate the association between EFT and coronary artery flow reserve (CFR), which is an early indicator of endothelial dysfunction in coronary vessels of HD patients. We performed a cross-sectional study including 71 chronic HD patients and 65 age- and sex-matched healthy controls. Epicardial fat tissue was significantly higher in HD patients when compared to healthy controls (6.53 ± 1.01 mm vs. 5.79 ± 1.06 mm, respectively, P < 0.001). On transthoracic Doppler echocardiography, CFR values were significantly lower in HD patients when compared to healthy controls (1.73 ± 0.11 vs. 2.32 ± 0.28, P < 0.001). Correlation analysis showed CFR values to be inversely correlated with EFT (r = -0.287, P < 0.05). Multiple linear regression analysis was used to define independent determinants of EFT in HD patients. Artery flow reserve, age, body mass index and total cholesterol levels were independently correlated with EFT thickness. This study demonstrated that EFT was significantly higher among HD patients compared to healthy controls. In addition, this study was the first to demonstrate an inverse correlation between EFT and CFR in this patient population.
心血管疾病（CVD）是血液透析（HD）患者死亡的主要原因。心外膜脂肪组织（EFT）是CVD中的一个新的风险因素。本研究的目的是评估EFT与冠状动脉血流储备（CFR）之间的关联，CFR是HD患者冠状动脉内皮功能障碍的早期指标。我们进行了一项横断面研究，纳入了71例慢性HD患者和65例年龄及性别匹配的健康对照者。与健康对照者相比，HD患者的心外膜脂肪组织明显更高（分别为6.53±1.01mm和5.79±1.06mm，P<0.001）。经胸多普勒超声心动图检查显示，与健康对照者相比，HD患者的CFR值明显更低（1.73±0.11对2.32±0.28，P<0.001）。相关性分析显示CFR值与EFT呈负相关（r=-0.287，P<0.05）。采用多元线性回归分析来确定HD患者中EFT的独立决定因素。动脉血流储备、年龄、体重指数和总胆固醇水平与EFT厚度独立相关。本研究表明，与健康对照者相比，HD患者中的EFT明显更高。此外，本研究首次证实在该患者群体中EFT与CFR之间存在负相关。
