Khawaja Tuba, Greer Christine, Thadani Samir R, Kato Tomoko S, Bhatia Ketan, Shimbo Daichi, Kontak Andrew, Bokhari Sabahat, Einstein Andrew J, Schulze P Christian
Division of Cardiology, Department of Medicine, New York-Presbyterian Hospital/Columbia University Medical Center, 622 W168th Street, PH10-203, New York, NY, 10032, USA.
J Nucl Cardiol. 2015 Apr;22(2):325-33. doi: 10.1007/s12350-014-0004-4. Epub 2014 Oct 24.
Epicardial adipose tissue is a source of pro-inflammatory cytokines and has been linked to the development of coronary artery disease. No study has systematically assessed the relationship between local epicardial fat volume (EFV) and myocardial perfusion defects. We analyzed EFV in patients undergoing SPECT myocardial perfusion imaging combined with computed tomography (CT) for attenuation correction. Low-dose CT without contrast was performed in 396 consecutive patients undergoing SPECT imaging for evaluation of coronary artery disease. Regional thickness, cross-sectional areas, and total EFV were assessed. 295 patients had normal myocardial perfusion scans and 101 had abnormal perfusion scans. Mean EFVs in normal, ischemic, and infarcted hearts were 99.8 ± 82.3 cm(3), 156.4 ± 121.9 cm(3), and 96.3 ± 102.1 cm(3), respectively (P < 0.001). Reversible perfusion defects were associated with increased local EFV compared to normal perfusion in the distribution of the right (69.2 ± 51.5 vs 46.6 ± 32.0 cm(3); P = 0.03) and left anterior descending coronary artery (87.1 ± 76.4 vs 46.7 ± 40.6 cm(3); P = 0.005). Our results demonstrate increased regional epicardial fat in patients with active myocardial ischemia compared to patients with myocardial scar or normal perfusion on nuclear perfusion scans. Our results suggest a potential role for cardiac CT to improve risk stratification in patients with suspected coronary artery disease.
心外膜脂肪组织是促炎细胞因子的来源，并且与冠状动脉疾病的发生有关。尚无研究系统评估局部心外膜脂肪体积（EFV）与心肌灌注缺损之间的关系。我们分析了接受单光子发射计算机断层扫描（SPECT）心肌灌注成像并结合计算机断层扫描（CT）进行衰减校正的患者的EFV。对396例连续接受SPECT成像以评估冠状动脉疾病的患者进行了无对比剂的低剂量CT检查。评估了局部厚度、横截面积和总EFV。295例患者心肌灌注扫描正常，101例患者灌注扫描异常。正常、缺血和梗死心脏的平均EFV分别为99.8±82.3cm³、156.4±121.9cm³和96.3±102.1cm³（P<0.001）。与正常灌注相比，可逆性灌注缺损与右冠状动脉（69.2±51.5 vs 46.6±32.0cm³；P=0.03）和左前降支冠状动脉（87.1±76.4 vs 46.7±40.6cm³；P=0.005）分布区域的局部EFV增加有关。我们的结果表明，与核灌注扫描显示心肌瘢痕或正常灌注的患者相比，活动性心肌缺血患者的局部心外膜脂肪增加。我们的结果提示心脏CT在疑似冠状动脉疾病患者的风险分层中可能具有潜在作用。
