Demircelik Muhammed Bora, Yilmaz Omer Caglar, Gurel Ozgul Malcok, Selcoki Yusuf, Atar Inci Asli, Bozkurt Alper, Akin Kayihan, Eryonucu Beyhan
Department of Cardiology, Turgut Ozal Un?vercity, Ankara, Turkey.
Department of Cardiology, Ankara Occupational Diseases Hospital, Ankara, Turkey.
Clinics (Sao Paulo). 2014 Jun;69(6):388-92. doi: 10.6061/clinics/2014(06)04.
The aim of the present study was to investigate the relationship between pericoronary fat and the severity and extent of atherosclerosis, quantified using 64-multidetector computed tomography, in patients with suspected coronary artery disease.
The study population consisted of 131 patients who were clinically referred for noninvasive multislice computed tomography coronary angiography for the evaluation of coronary artery disease. Patients were classified as follows: no atherosclerosis, Group 1; nonobstructive atherosclerosis (luminal narrowing <50% in diameter), Group 2; and obstructive atherosclerosis (luminal narrowing ≥ 50%) in a single vessel or obstructive atherosclerosis in the left main coronary artery and/or multiple vessels, Group 3. Epicardial adipose tissue was defined as the adipose tissue between the surface of the heart and the visceral layer of the pericardium (visceral epicardium). Epicardial adipose tissue thickness (mm) was determined in the right ventricular anterior free wall. The mean thickness of the pericoronary fat surrounding the three coronary arteries was used for the analyses.
The average thickness over all three regions was 13.2 ± 2.1 mm. The pericoronary fat thickness was significantly increased in Group 3 compared with Groups 2 and 1. The epicardial adipose tissue thickness was significantly increased in Group 3 compared with Groups 2 and 1. A receiver operating characteristic curve for obstructive coronary artery disease was assessed to verify the optimum cut-off point for pericoronary fat thickness, which was 13.8 mm. A receiver operating characteristic curve for obstructive coronary artery disease was also assessed to verify the optimum cut-off point for epicardial adipose tissue, which was 6.8 cm.
We showed that the epicardial adipose tissue and pericoronary fat thickness scores were higher in patients with obstructive coronary artery diseases.
本研究旨在探讨疑似冠心病患者的冠状动脉周围脂肪与动脉粥样硬化的严重程度及范围之间的关系，采用64层螺旋计算机断层扫描进行量化分析。
研究对象包括131例因临床需要接受无创多层螺旋计算机断层扫描冠状动脉造影以评估冠状动脉疾病的患者。患者分为以下几组：无动脉粥样硬化，第1组；非阻塞性动脉粥样硬化（管腔直径狭窄<50%），第2组；单支血管阻塞性动脉粥样硬化（管腔直径狭窄≥50%）或左主干冠状动脉和/或多支血管阻塞性动脉粥样硬化，第3组。心外膜脂肪组织定义为心脏表面与心包脏层（脏层心外膜）之间的脂肪组织。在心右室前游离壁测定心外膜脂肪组织厚度（毫米）。分析时采用围绕三根冠状动脉的冠状动脉周围脂肪的平均厚度。
所有三个区域的平均厚度为13.2±2.1毫米。与第2组和第l组相比，第3组的冠状动脉周围脂肪厚度显著增加。与第2组和第1组相比，第3组的心外膜脂肪组织厚度显著增加。评估了阻塞性冠状动脉疾病的受试者工作特征曲线，以验证冠状动脉周围脂肪厚度的最佳切点，为13.8毫米。还评估了阻塞性冠状动脉疾病的受试者工作特征曲线，以验证心外膜脂肪组织的最佳切点，为6.8厘米。
我们发现，阻塞性冠状动脉疾病患者的心外膜脂肪组织和冠状动脉周围脂肪厚度评分更高。
