Lai Yau-Huei, Hou Charles Jia-Yin, Yun Chun-Ho, Sung Kuo-Tzu, Su Cheng-Huang, Wu Tung-Hsin, Yang Fei-Shih, Hung Ta-Chuan, Hung Chung-Lieh, Bezerra Hiram G, Yeh Hung-I
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Road, Taipei, Taiwan.
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Hsinchu, Taiwan.
BMC Cardiovasc Disord. 2015 Oct 30;15:142. doi: 10.1186/s12872-015-0136-8.
Visceral adipose tissue, a biologically active fat depot, has been proposed as a reliable marker for visceral adiposity and metabolic abnormalities. Effects of such adiposity on LV diastolic function and dyssynchrony remained largely unknown.
We assessed pericardial fat (PCF) and thoracic peri-aortic fat (TPAF) by three-dimensional (3D) volume-vender multi-detector computed tomography (MDCT) (Aquarius 3D Workstation, TeraRecon, San Mateo, CA, USA). Echo-derived diastolic parameters and tissue Doppler imaging (TDI) defined mitral annular systolic (S'), early diastolic (E') velocities as well as LV filling (E/E') were all obtained. Intra-ventricular systolic (Sys-D) and diastolic (Dias-D) dyssynchrony were assessed by TDI method.
A total of 318 asymptomatic subjects (mean age: 53.5 years, 36.8 % female) were eligible in this study. Greater PCF and TPAF were both associated with unfavorable diastolic indices and higher diastolic dyssynchrony (all p < 0.05). These associations remained relatively unchanged in multi-variate models. PCF and TPAF set at 81.68 & 8.11 ml yielded the largest sensitivity and specificity (78.6 and 60 % for PCF, 75 and 66.6 % for TPAF, respectively) in predicting abnormally high LV diastolic dyssynchrony, which was defined as Dias-D≧55 ms.
Increasing visceral adiposity may be associated with adverse effects on myocardium, primarily featured by worse diastolic function and greater degree of dyssynchrony.
内脏脂肪组织是一种具有生物活性的脂肪库，已被提议作为内脏肥胖和代谢异常的可靠标志物。这种肥胖对左心室舒张功能和不同步性的影响在很大程度上仍不清楚。
我们通过三维（3D）容积探测器多排螺旋计算机断层扫描（MDCT）（水瓶座3D工作站，TeraRecon，美国加利福尼亚州圣马特奥）评估心包脂肪（PCF）和胸主动脉周围脂肪（TPAF）。获得了超声心动图衍生的舒张参数和组织多普勒成像（TDI）定义的二尖瓣环收缩期（S'）、舒张早期（E'）速度以及左心室充盈（E/E'）。通过TDI方法评估心室内收缩期（Sys-D）和舒张期（Dias-D）不同步性。
本研究共纳入318名无症状受试者（平均年龄：53.5岁，女性占36.8%）。较高的PCF和TPAF均与不良舒张指标和较高的舒张期不同步性相关（所有p<0.05）。在多变量模型中，这些关联保持相对不变。在预测左心室舒张不同步性异常升高（定义为Dias-D≧55毫秒）时，PCF和TPAF分别设定为81.68和8.11毫升时，敏感性和特异性最高（PCF分别为78.6%和60%，TPAF分别为75%和66.6%）。
内脏肥胖增加可能与对心肌的不良影响有关，主要表现为舒张功能恶化和不同步程度增加。
