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稳定型冠状动脉疾病患者的心外膜脂肪厚度:其与高敏心肌肌钙蛋白T及N末端脑钠肽前体的关系

Epicardial fat thickness in stable coronary artery disease: its relationship with high-sensitive cardiac troponin T and N-terminal pro-brain natriuretic peptide.

作者信息

Börekçi Abdurrezzak, Gür Mustafa, Özaltun Betül, Baykan Ahmet Oytun, Harbalioğlu Hazar, Seker Taner, Sen Ömer, Acele Armağan, Gözükara Mehmet Yavuz, Kuloğlu Osman, Koç Mevlüt, Çayli Murat

机构信息

aDepartment of Cardiology, School of Medicine, Kafkas University, Kars bDepartment of Cardiology, Adana Numune Training and Research Hospital, Adana cDepartment of Internal Medicine, Mersin State Hospital, Mersin, Turkey.

出版信息

Coron Artery Dis. 2014 Dec;25(8):685-90. doi: 10.1097/MCA.0000000000000140.

Abstract

OBJECTIVES

Epicardial adipose tissue is related to coronary atherosclerosis, left ventricle hypertrophy, myocardial dysfunction, cardiomyopathy, and inflammation, which produces a variety of cytokines that influence key pathogenic mechanisms of atherogenesis. The main goal of this study is to examine the relationship between epicardial fat thickness (EFT) and cardiovascular risk markers as well as the complexity of coronary artery disease (CAD) in patients with stable CAD.

MATERIALS AND METHODS

We prospectively included 439 stable CAD patients undergoing coronary angiography in the present study (mean age: 62.2±10.7 years). Patients were divided into two groups (EFTlow and EFThigh groups) according to their median EFT values. EFT was evaluated by two-dimensional echocardiography before angiography. The SYNTAX score was calculated in all patients. N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP), high-sensitive cardiac troponin T (hs-cTnT), uric acid, and other biochemical markers were also measured.

RESULTS

Age, SYNTAX score, frequencies of diabetes, hyperlipidemia, and hypertension, NT-proBNP, hs-CRP, hs-cTnT, and uric acid levels were higher in EFThigh group compared with the EFTlow group (P<0.05 for all). EFT was associated independently with age (β=-0.102, P=0.001), diabetes (β=-0.083, P=0.011), SYNTAX score (β=0.352, P<0.001), hs-CRP level (β=0.217, P<0.001), hs-cTnT level (β=0.197, P<0.001), and NT-proBNP level (β=0.300, P<0.001) in multivariate analysis.

CONCLUSION

EFT obtained by echocardiograpy may not only be an easy tool but also an important tool for early detection of increased cardiac risk as well as the extent and complexity of CAD in patients with stable CAD.

摘要

目的

心外膜脂肪组织与冠状动脉粥样硬化、左心室肥厚、心肌功能障碍、心肌病及炎症相关,其可产生多种细胞因子,影响动脉粥样硬化形成的关键致病机制。本研究的主要目的是探讨稳定型冠心病患者的心外膜脂肪厚度(EFT)与心血管风险标志物以及冠状动脉疾病(CAD)复杂性之间的关系。

材料与方法

本研究前瞻性纳入了439例接受冠状动脉造影的稳定型冠心病患者(平均年龄:62.2±10.7岁)。根据患者的EFT中位数将其分为两组(EFT低组和EFT高组)。在血管造影术前通过二维超声心动图评估EFT。计算所有患者的SYNTAX评分。还测量了N末端脑钠肽前体(NT-proBNP)、高敏C反应蛋白(hs-CRP)、高敏心肌肌钙蛋白T(hs-cTnT)、尿酸及其他生化标志物。

结果

与EFT低组相比,EFT高组的年龄、SYNTAX评分、糖尿病、高脂血症和高血压的发生率、NT-proBNP、hs-CRP、hs-cTnT及尿酸水平更高(所有P<0.05)。在多因素分析中,EFT与年龄(β=-0.102,P=0.001)、糖尿病(β=-0.083,P=0.011)、SYNTAX评分(β=0.352,P<0.001)、hs-CRP水平(β=\(0.217\),P<0.001)、hs-cTnT水平(β=0.197,P<0.001)及NT-proBNP水平(β=0.300,P<0.001)独立相关。

结论

通过超声心动图获得的EFT不仅可能是一种简便的工具,而且是早期检测稳定型冠心病患者心脏风险增加以及CAD程度和复杂性的重要工具。

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