Tsushima Hiroshi, Yamamoto Hideya, Kitagawa Toshiro, Urabe Yoji, Tatsugami Fuminari, Awai Kazuo, Kihara Yasuki
Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences.
Circ J. 2015;79(5):1084-91. doi: 10.1253/circj.CJ-14-1169. Epub 2015 Feb 24.
We sought to examine whether epicardial and abdominal visceral adipose tissue distribution is associated with coronary atherosclerosis in patients with a coronary artery calcium (CAC) score of zero, assessed by coronary computed tomography angiography (CCTA).
We studied 352 patients with suspected coronary artery disease (mean age 61±11 years, 57% male) with a CAC score of zero who had undergone CCTA. Non-calcified coronary plaques (NCPs) were detected in 102 patients (29%); those causing ≥50% stenosis were found in 15 patients (4%). Patients were divided into 4 groups on the basis of CT-based epicardial adipose tissue (EAT) volume and abdominal visceral adipose tissue (VAT) area using the sex-specific median value. Multivariate analysis showed that the adjusted odds ratios for the presence of NCPs in the high VAT area/low EAT volume group, and the high VAT area/high EAT volume group were 2.80 (95% confidence interval [95% CI]: 1.25-6.35, P=0.01) and 2.68 (95% CI: 1.36-5.45, P=0.004), respectively. Interestingly, the low VAT area/high EAT volume group showed an equivalent adjusted odds ratio of 3.02 (95% CI: 1.33-6.90, P=0.008).
EAT volume is eligible as a marker to be evaluated in addition to VAT area in patients with a CAC score of zero.
我们试图通过冠状动脉计算机断层扫描血管造影（CCTA）检查冠状动脉钙化（CAC）评分为零的患者的心外膜和腹部内脏脂肪组织分布是否与冠状动脉粥样硬化相关。
我们研究了352例疑似冠状动脉疾病（平均年龄61±11岁，57%为男性）且CAC评分为零并接受了CCTA检查的患者。102例患者（29%）检测到非钙化冠状动脉斑块（NCPs）；其中15例患者（4%）存在导致≥50%狭窄的斑块。根据基于CT的心外膜脂肪组织（EAT）体积和腹部内脏脂肪组织（VAT）面积的性别特异性中位数，将患者分为4组。多变量分析显示，高VAT面积/低EAT体积组和高VAT面积/高EAT体积组中存在NCPs的校正比值比分别为2.80（95%置信区间[95%CI]：1.25 - 6.35，P = 0.01）和2.68（95%CI：1.36 - 5.45，P = 0.004）。有趣的是，低VAT面积/高EAT体积组的校正比值比为3.02（95%CI：1.33 - 6.90，P = 0.008），与之相当。
对于CAC评分为零的患者，除了VAT面积外，EAT体积也有资格作为一个需要评估的指标。
