Zencirci Ertuğrul, Zencirci Aycan Esen, Değirmencioğlu Aleks, Karakuş Gültekin, Uğurlucan Murat, Özden Kıvılcım, Erdem Aysun, Güllü Ahmet Ümit, Ekmekçi Ahmet, Velibey Yalçın, Erer Hatice Betül, Çelik Seden, Akyol Ahmet
Department of Cardiology, Acibadem Maslak Hospital, Buyukdere C. 40 Maslak/Sarıyer, 34457, Istanbul, Turkey,
Heart Vessels. 2015 Mar;30(2):147-53. doi: 10.1007/s00380-013-0459-2. Epub 2014 Jan 12.
The relationship between epicardial adipose tissue (EAT) and coronary artery disease has been predominantly demonstrated in the last two decades. The aim of this study was to investigate the predictive value of EAT thickness on ST-segment resolution that reflects myocardial reperfusion in patients undergoing primary percutaneous coronary intervention (pPCI) for acute ST-segment elevation myocardial infarction (STEMI). The present study prospectively included 114 consecutive patients (mean age 54 ± 10 years, range 35-83, 15 women) with first acute STEMI who underwent successful pPCI. ST-segment resolution (ΔSTR) <70 % was accepted as ECG sign of no-reflow phenomenon. The EAT thickness was measured by two-dimensional echocardiography. EAT thickness was increased in patients with no-reflow (3.9 ± 1.7 vs. 5.4 ± 2, p = 0.001). EAT thickness was also found to be inversely correlated with ΔSTR (r = -0.414, p = 0.001). Multivariate logistic regression analysis demonstrated that EAT thickness independently predicted no-reflow (OR 1.43, 95 % CI 1.13-1.82, p = 0.003). Receiver operating characteristic curve analysis demonstrated good diagnostic accuracy for EAT thickness in predicting no-reflow [area under curve (AUC) = 0.72, 95 % CI 0.63-0.82, p < 0.001]. In conclusion, increased EAT thickness may play an important role in the prediction of no-reflow in STEMI treated with pPCI.
近二十年来，心外膜脂肪组织（EAT）与冠状动脉疾病之间的关系已得到充分证实。本研究旨在探讨EAT厚度对接受直接经皮冠状动脉介入治疗（pPCI）的急性ST段抬高型心肌梗死（STEMI）患者心肌再灌注的ST段分辨率的预测价值。本研究前瞻性纳入了114例连续的首次急性STEMI患者（平均年龄54±10岁，范围35 - 83岁，15例女性），这些患者均成功接受了pPCI。ST段分辨率（ΔSTR）<70%被视为无复流现象的心电图表现。通过二维超声心动图测量EAT厚度。无复流患者的EAT厚度增加（3.9±1.7 vs. 5.4±2，p = 0.001）。还发现EAT厚度与ΔSTR呈负相关（r = -0.414，p = 0.001）。多因素逻辑回归分析表明，EAT厚度可独立预测无复流（OR 1.43，95%CI 1.13 - 1.82，p = 0.003）。受试者工作特征曲线分析表明，EAT厚度在预测无复流方面具有良好的诊断准确性[曲线下面积（AUC）= 0.72，95%CI 0.63 - 0.82，p < 0.001]。总之，EAT厚度增加可能在pPCI治疗的STEMI患者无复流预测中起重要作用。
