顽固性高血压患者的心外膜脂肪组织厚度评估

Assessment of epicardial adipose tissue thickness in patients with resistant hypertension.

作者信息

Erdogan Güney, Belen Erdal, Sungur Mustafa A, Sungur Aylin, Yaylak Bariş, Güngör Bariş, Akyüz Şükrü, Satilmiş Seçkin

机构信息

aDepartment of Cardiology, Ordu State Hospital, Ordu bDepartment of Cardiology, Okmeydani Training and Research Hospital cDepartment of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital dDepartment of Cardiology, School of Medicine, Acibadem University, Istanbul eDepartment of Cardiology, Kahramanmaraş Necip Fazil City Hospital, Kahramanmaraş fDepartment of Cardiology, Diyarbakir Gazi Yaşargil Training and Reseasrch Hospital, Diyarbakir, Turkey.

出版信息

Blood Press Monit. 2016 Feb;21(1):16-20. doi: 10.1097/MBP.0000000000000149.

DOI:10.1097/MBP.0000000000000149

PMID:26317386

Abstract

OBJECTIVE

Recent studies have shown that epicardial adipose tissue (EAT) thickness is increased in patients with hypertension. In this study, we aimed to investigate the relation of EAT thickness with resistant hypertension (RHT).

PARTICIPANTS AND METHODS

Study participants (n=150) were classified into three groups according to their office and ambulatory blood pressure measurements: RHT (n=50), controlled hypertension (CHT, n=50), and normotension (NT, n=50). All patients underwent a transthoracic echocardiographic examination to measure EAT thickness.

RESULTS

Clinical and biochemical characteristics of the groups were similar, except the CRP level, which was significantly increased in hypertensive patients compared with patients with NT (P<0.001). EAT thickness differed significantly between groups (P<0.001). The highest values were obtained in the RHT group (4.64±1.24 cm), followed by the CHT (3.3±0.82 cm) and NT (2.6±0.76 cm) groups. Multivariate analysis indicated age, physical activity level, and EAT thickness as independent predictors of RHT. The optimal cut-off value of EAT thickness for detection of RHT was found to be 3.42 cm, with a sensitivity and specificity of 82 and 77%, respectively (AUC=0.87, 95% confidence interval 0.81-0.92, P<0.000).

CONCLUSION

EAT can be effective on blood pressure by several mechanisms. In this study, for the first time in the literature, the association of EAT with RHT is reported.

摘要

目的

近期研究表明，高血压患者的心外膜脂肪组织（EAT）厚度增加。在本研究中，我们旨在探讨EAT厚度与顽固性高血压（RHT）之间的关系。

参与者与方法

根据诊室血压和动态血压测量结果，将研究参与者（n = 150）分为三组：RHT组（n = 50）、血压控制良好的高血压组（CHT，n = 50）和正常血压组（NT，n = 50）。所有患者均接受经胸超声心动图检查以测量EAT厚度。

结果

除CRP水平外，各组的临床和生化特征相似，与NT组患者相比，高血压患者的CRP水平显著升高（P < 0.001）。各组之间的EAT厚度差异显著（P < 0.001）。RHT组的值最高（4.64±1.24 cm），其次是CHT组（3.3±0.82 cm）和NT组（2.6±0.76 cm）。多变量分析表明年龄、身体活动水平和EAT厚度是RHT的独立预测因素。发现检测RHT的EAT厚度最佳截断值为3.42 cm，敏感性和特异性分别为82%和77%（AUC = 0.87，95%置信区间0.81 - 0.92，P < 0.000）。