体重减轻对心房颤动患者心包脂肪组织和心脏结构的影响。
Impact of weight reduction on pericardial adipose tissue and cardiac structure in patients with atrial fibrillation.
作者信息
Abed Hany S, Nelson Adam J, Richardson James D, Worthley Stephen G, Vincent Andrew, Wittert Gary A, Leong Darryl P
机构信息
NHMRC Clinical Trials Center, University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia; University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
University of Adelaide and Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
出版信息
Am Heart J. 2015 May;169(5):655-662.e2. doi: 10.1016/j.ahj.2015.02.008. Epub 2015 Feb 21.
BACKGROUND
Obesity and pericardial adipose tissue are independent risk factors for atrial fibrillation (AF) and adverse cardiac structural remodeling. The effect of weight reduction on pericardial adipose tissue and cardiac structure remains unknown.
METHODS
We prospectively performed cardiac magnetic resonance imaging on 87 participants with AF undergoing either structured weight management (intervention) or general lifestyle advice (control). We measured pericardial adipose tissue, atrial and ventricular volumes, and myocardial mass at baseline and 12 months.
RESULTS
In total, 69 participants underwent baseline and 12-month follow-up cardiac magnetic resonance imaging (intervention n = 36 and controls n = 33). From baseline to 12 months, weight loss (kg, mean [95% CI]) was greater in the intervention group from 101.5 kg (97.2-105.8 kg) to 86.5 kg (81.2-91.9 kg) as compared with controls from 102.6 kg (97.2-108.1 kg) to 98.7 kg (91.0-106.3 kg) (time-group interaction P < .001). The intervention group showed a reduction in left atrial volumes (mL) from 105.0 mL (98.9-111.1 mL) to 96.4 mL (91.6-101.1 mL), whereas the change in the control group was from 108.8 mL (99.6-117.9 mL) to 108.9 mL (99.8-118.0 mL) (time-group interaction P < .001). There was a decline in pericardial adipose tissue (cm(3)) from 140.9 cm(3) (129.3-152.4 cm(3)) to 118.8 cm(3) (108.1-129.6 cm(3)) and myocardial mass (g) from 137.6 g (128.1-147.2 g) to 123.1 g (114.5-131.7 g) in the intervention group, whereas the change in the control group was from 143.2 cm(3) (124.6-161.7 cm(3)) to 147.2 cm(3) (128.9-165.4 cm(3)) for pericardial adipose tissue and 138.3 g (124.8-151.8 g) to 140.7 g (127.4-154.1 g) for myocardial mass (both variables, time-group interaction P < .001).
CONCLUSIONS
Weight reduction results in favorable structural remodeling and a reduction in pericardial adipose tissue burden.
背景
肥胖和心包脂肪组织是心房颤动（AF）及不良心脏结构重塑的独立危险因素。体重减轻对心包脂肪组织和心脏结构的影响尚不清楚。
方法
我们前瞻性地对87例接受结构化体重管理（干预组）或一般生活方式建议（对照组）的房颤参与者进行了心脏磁共振成像检查。我们在基线和12个月时测量了心包脂肪组织、心房和心室容积以及心肌质量。
结果
共有69例参与者接受了基线和12个月随访的心脏磁共振成像检查（干预组n = 36，对照组n = 33）。从基线到12个月，干预组的体重减轻（kg，均值[95%CI]）幅度大于对照组，干预组从101.5 kg（97.2 - 105.8 kg）降至86.5 kg（81.2 - 91.9 kg），而对照组从102.6 kg（97.2 - 108.1 kg）降至98.7 kg（91.0 - 106.3 kg）（时间 - 组间交互作用P <.001）。干预组左心房容积（mL）从105.0 mL（98.9 - 111.1 mL）降至96.4 mL（91.6 - 101.1 mL），而对照组的变化是从108.8 mL（99.6 - 117.9 mL）至108.9 mL（99.8 - 118.0 mL）（时间 - 组间交互作用P <.001）。干预组心包脂肪组织（cm³）从140.9 cm³（129.3 - 152.4 cm³）降至118.8 cm³（108.1 - 129.6 cm³），心肌质量（g）从137.6 g（128.1 - 147.2 g）降至123.1 g（114.5 - 131.7 g），而对照组心包脂肪组织的变化是从143.2 cm³（124.6 - 161.7 cm³）至147.2 cm³（128.9 - 165.4 cm³），心肌质量从138.3 g（124.8 - 151.8 g）至140.7 g（127.4 - 154.1 g）（两个变量的时间 - 组间交互作用P <.001）。
结论
体重减轻可导致有利的结构重塑并减轻心包脂肪组织负担。
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