Aydın Elcin, Altın Cihan, Sakallıoğlu Onur, Yılmaz Mustafa, Gezmiş Esin, Elif Sade Leyla, Müderrisoğlu Haldun
Department of Radiology.
Department of Cardiology.
Acta Cardiol Sin. 2017 May;33(3):266-272. doi: 10.6515/acs20161023a.
It is well-known that cardiovascular risk and all-cause mortality is increased in hemodialysis patients. Epicardial fat thickness (EFT), which reflects visceral adiposity, has been suggested as a new cardiometabolic risk factor. The purpose of this study was to investigate EFT in hemodialysis patients.
A total of 144 consecutive patients (60 hemodialysis patients and 84 controls) were enrolled into the study, and patients with diabetes mellitus and cardiovascular diseases (CVD) were excluded. EFT was measured on the free wall of the right ventricle at end-diastole from the parasternal long-axis view by standard transthorasic 2D echocardiography.
The groups were similar in terms of sex distribution, age, blood pressure, heart rate and frequencies of CAD risk factors including smoking status, family history of CAD and hypertension. There were no significant differences between the hemodialysis patients and controls in 2D echocardiographic parameters, including ejection fraction and biochemical parameters except low-density lipoprotein, high-density lipoprotein and c- reactive protein. Despite having lower body mass index, EFT levels were significantly higher in hemodialysis patients compared to the controls (8.0 ± 2.2 mm vs. 5.8 ± 1.9 mm; p < 0.01). In multivariate linear regression analysis we determined that hemodialysis patient status was found to be an independent predictor for both EFT (β = 0. 700, p = 0.014) and carotid intima-media thickness (CIMT, β = 0. 614, p = 0.047).
Hemodialysis patients are independently associated with high EFT and CIMT.
众所周知，血液透析患者的心血管风险和全因死亡率会增加。反映内脏肥胖的 epicardial fat thickness（EFT）已被认为是一种新的心脏代谢风险因素。本研究的目的是调查血液透析患者的 EFT。
总共 144 例连续患者（60 例血液透析患者和 84 例对照）纳入本研究，排除患有糖尿病和心血管疾病（CVD）的患者。通过标准经胸二维超声心动图从胸骨旁长轴视图在舒张末期测量右心室游离壁的 EFT。
两组在性别分布、年龄、血压、心率以及包括吸烟状况、CAD 家族史和高血压在内的 CAD 风险因素频率方面相似。血液透析患者和对照组在二维超声心动图参数（包括射血分数）和生化参数（除低密度脂蛋白、高密度脂蛋白和 c 反应蛋白外）方面无显著差异。尽管体重指数较低，但血液透析患者的 EFT 水平显著高于对照组（8.0±2.2mm 对 5.8±1.9mm；p<0.01）。在多变量线性回归分析中，我们确定血液透析患者状态是 EFT（β=0.700，p=0.014）和颈动脉内膜中层厚度（CIMT，β=0.614，p=0.047）的独立预测因素。
血液透析患者与高 EFT 和 CIMT 独立相关。
