Erkan Aycan Fahri, Tanindi Asli, Kocaman Sinan Altan, Ugurlu Murat, Tore Hasan Fehmi
Tex Heart Inst J. 2016 Feb 1;43(1):29-37. doi: 10.14503/THIJ-14-4850. eCollection 2016 Feb.
Epicardial adipose tissue thickness is associated with the severity and extent of atherosclerotic coronary artery disease. We prospectively investigated whether epicardial adipose tissue thickness is related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and whether the thickness predicts critical disease. After performing coronary angiography in 183 patients who had angina or acute myocardial infarction, we divided them into 3 groups: normal coronary arteries, noncritical disease (≥1 coronary lesion with <70% stenosis), and critical disease (≥1 coronary lesion with <70% stenosis). We used transthoracic echocardiography to measure epicardial adipose tissue thickness, then calculated Gensini and Syntax scores by reviewing the angiograms. Mean thicknesses were 4.3 ± 0.9, 5.2 ± 1.5, and 7.5 ± 1.9 mm in patients with normal coronary arteries, noncritical disease, and critical disease, respectively (P <0.001). At progressive thicknesses (<5, 5-7, and >7 mm), mean Gensini scores were 4.1 ± 5.5, 19.8 ± 15.6, and 64.9 ± 32.4, and mean Syntax scores were 4.7 ± 5.9, 16.6 ± 8.5, and 31.7 ± 8.7, respectively (both P <0.001). Thickness had strong and positive correlations with both scores (Gensini, r =0.82, P <0.001; and Syntax, r =0.825, P <0.001). The cutoff thickness value to predict critical disease was 5.75 mm (area under the curve, 0.875; 95% confidence interval, 0.825-0.926; P <0.001). Epicardial adipose tissue thickness is independently related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and it predicts critical coronary artery disease.
心外膜脂肪组织厚度与动脉粥样硬化性冠状动脉疾病的严重程度和范围相关。我们前瞻性地研究了心外膜脂肪组织厚度是否与用Gensini评分和Syntax评分表示的冠状动脉疾病范围及复杂性相关，以及该厚度是否能预测严重疾病。在对183例患有心绞痛或急性心肌梗死的患者进行冠状动脉造影后，我们将他们分为3组：正常冠状动脉组、非严重疾病组（≥1处冠状动脉病变且狭窄程度<70%）和严重疾病组（≥1处冠状动脉病变且狭窄程度≥70%）。我们使用经胸超声心动图测量心外膜脂肪组织厚度，然后通过回顾血管造影来计算Gensini评分和Syntax评分。正常冠状动脉组、非严重疾病组和严重疾病组患者的心外膜脂肪组织平均厚度分别为4.3±0.9、5.2±1.5和7.5±1.9毫米（P<0.001）。在逐渐增加的厚度（<5、5 - 7和>7毫米）下，平均Gensini评分分别为4.1±5.5、19.8±15.6和64.9±32.4，平均Syntax评分分别为4.7±5.9、16.6±8.5和31.7±8.7（均P<0.001）。厚度与这两个评分均呈强正相关（Gensini评分，r = 0.82，P<0.001；Syntax评分，r = 0.825，P<0.001）。预测严重疾病的心外膜脂肪组织厚度临界值为5.75毫米（曲线下面积，0.875；95%置信区间，0.825 - 0.926；P<0.001）。心外膜脂肪组织厚度与用Gensini评分和Syntax评分表示的冠状动脉疾病范围及复杂性独立相关，并且它能预测严重冠状动脉疾病。
