Hachiya Kenta, Fukuta Hidekatsu, Wakami Kazuaki, Goto Toshihiko, Tani Tomomitsu, Ohte Nobuyuki
Department of Cardio-Renal Medicine and Hypertension, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
Int J Cardiovasc Imaging. 2014 Oct;30(7):1393-8. doi: 10.1007/s10554-014-0472-2. Epub 2014 Jun 19.
The present study tested the hypothesis that epicardial fat may be associated with augmented central aortic pressure and impaired left ventricular (LV) function. We studied 134 consecutive patients undergoing left-sided cardiac catheterization for coronary artery disease (CAD) and examined the relation of epicardial fat volume measured by multi-detector computed tomography to ascending aortic pressure and LV ejection fraction determined by cardiac catheterization as well as indices of LV diastolic function assessed by Doppler echocardiography [early diastolic mitral annular velocity (e') and a ratio of early diastolic mitral inflow to annular velocities (E/e')]. Epicardial fat volume indexed to body surface area correlated positively with age (r = 0.24, P < 0.01), body mass index (r = 0.38, P < 0.001), systolic aortic pressure (r = 0.21, P < 0.05), aortic pulse pressure (r = 0.23, P < 0.01), LV ejection fraction (r = 0.22, P < 0.05) and E/e' (r = 0.24, P < 0.05) and did negatively with e' (r = -0.31, P < 0.05). In multivariate linear regression including potential confounders, increased epicardial fat volume index correlated with aortic systolic and pulse pressure and LV diastolic function indices, but not LV ejection fraction. In conclusion, we found that epicardial fat was associated with augmented central aortic pressure and LV diastolic dysfunction in patients with known or suspected CAD.
心外膜脂肪可能与中心主动脉压升高及左心室(LV)功能受损有关。我们研究了134例因冠心病(CAD)连续接受左侧心导管检查的患者,并通过多排螺旋计算机断层扫描测量心外膜脂肪体积,探讨其与心导管检查测定的升主动脉压和左心室射血分数以及多普勒超声心动图评估的左心室舒张功能指标[二尖瓣环舒张早期速度(e')以及二尖瓣舒张早期血流与环速度之比(E/e')]之间的关系。以体表面积指数化的心外膜脂肪体积与年龄呈正相关(r = 0.24,P < 0.01)、与体重指数呈正相关(r = 0.38,P < 0.001)、与主动脉收缩压呈正相关(r = 0.21,P < 0.05)、与主动脉脉压呈正相关(r = 0.23,P < 0.01)、与左心室射血分数呈正相关(r = 0.22,P < 0.05)以及与E/e'呈正相关(r = 0.24,P < 0.05),而与e'呈负相关(r = -0.31,P < 0.05)。在纳入潜在混杂因素的多变量线性回归分析中,心外膜脂肪体积指数升高与主动脉收缩压、脉压以及左心室舒张功能指标相关,但与左心室射血分数无关。总之,我们发现,在已知或疑似患有CAD的患者中,心外膜脂肪与中心主动脉压升高及左心室舒张功能障碍有关。