Sen Fatih, Yilmaz Samet, Sen Ömer, Balc Kevser Gülcihan, Duman İlker, Topaloglu Serkan, Temizhan Ahmet, Aras Dursun
Cardiology clinic, Turkey Yuksek Ihtisas Education and Research Hospital , Sihhiye, Ankara , Turkey.
Scand Cardiovasc J. 2015 Jun;49(3):130-5. doi: 10.3109/14017431.2015.1023345. Epub 2015 Apr 2.
Epicardial adipose tissue (EAT) is the ectopic fat surrounding the heart, and it may contribute to coronary collateral vessel (CCV) formation. We aimed to evaluate the association of EAT with the presence of CCV in patients with acute coronary syndrome (ACS).
A total of 230 patients with ACS were included. The CCVs were graded according to the Rentrop scoring system, and a Rentrop grade 0-1 was accepted as low-grade CCV group, Rentrop grade 2-3 was accepted as high-grade CCV group.
According to angiography, 70 (30%) patients constituted the high-grade CCV group and 160 (70%) constituted the low-grade CCV group. The high-grade CCV group had thicker EAT than the low-grade CCV group (6.1 ± 1.4 vs. 5.3 ± 1.4 mm; p = 0.001). Multivariate logistic regression analysis showed that presence of CCV was independently associated with EAT thickness, ejection fraction, presenting with ST-segment elevation myocardial infarction, and presence of angina on admission. EAT thickness of > 5.7 mm can independently predict high-grade CCV with 73% sensitivity and 69% specificity (area under the curve or AUC: 0.65; 95% confidence interval or CI: 0.57-0.72).
EAT thickness on admission was associated with the presence of CCVs in patients with ACS.
心外膜脂肪组织（EAT）是心脏周围的异位脂肪，可能有助于冠状动脉侧支血管（CCV）的形成。我们旨在评估急性冠状动脉综合征（ACS）患者中EAT与CCV存在之间的关联。
共纳入230例ACS患者。根据Rentrop评分系统对CCV进行分级，Rentrop 0-1级被视为低级别CCV组，Rentrop 2-3级被视为高级别CCV组。
根据血管造影，70例（30%）患者构成高级别CCV组，160例（70%）构成低级别CCV组。高级别CCV组的EAT比低级别CCV组更厚（6.1±1.4 vs. 5.3±1.4毫米；p = 0.001）。多因素逻辑回归分析显示，CCV的存在与EAT厚度、射血分数、表现为ST段抬高型心肌梗死以及入院时是否存在心绞痛独立相关。EAT厚度>5.7毫米可独立预测高级别CCV，敏感性为73%，特异性为69%（曲线下面积或AUC：0.65；95%置信区间或CI：0.57-0.72）。
入院时的EAT厚度与ACS患者中CCV的存在相关。
