Acele Armağan, Baykan Ahmet O, Yüksel Kalkan Gülhan, Çeliker Emel, Gür Mustafa
Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey.
Echocardiography. 2017 Aug;34(8):1146-1151. doi: 10.1111/echo.13600. Epub 2017 Jul 3.
Although the relationship between epicardial fat thickness (EFTh) and coronary atherosclerosis is well established, this relation in the early periods of atherosclerosis has not been fully demonstrated. On the other hand, thoracic aortic intima-media thickness (IMT) rather than carotid IMT was reported as an earlier marker of preclinical atherosclerosis.
We aimed to assess the relationship between thoracic aortic IMT and EFTh in patients undergoing transesophageal echocardiography (TEE) examination for different indications.
We included 104 patients (mean age 38±11.4 years), who underwent TEE for various indications. The patients were divided into two groups according to the median thoracic aortic IMT values (IMT normal group<10 mm and IMT abnormal group≥10 mm). EFTh was obtained using two-dimensional transthoracic echocardiography on the right ventricular free wall during systole and diastole.
The highest EFTh values (3.3±0.96 mm vs. 4.51±0.66 mm, P<.001) were observed in the abnormal aortic IMT group. Multivariate linear regression analysis showed that aortic IMT was independently correlate with EFTh (β=0.423, P<.001). Moreover, EFTh was found to be associated with history of transient ischemic attack (r=.403, P<.001) and abnormal IMT (r=.643, P<.001) in bivariate analysis.
Epicardial fat thickness is independently related to the extent of subclinical thoracic aortic atherosclerosis. Increase in EFTh may be crucial marker for initial atherosclerosis.
虽然心外膜脂肪厚度(EFTh)与冠状动脉粥样硬化之间的关系已得到充分证实,但在动脉粥样硬化早期阶段的这种关系尚未得到充分证明。另一方面,有报道称胸主动脉内膜中层厚度(IMT)而非颈动脉IMT是临床前期动脉粥样硬化的早期标志物。
我们旨在评估因不同适应证接受经食管超声心动图(TEE)检查的患者中胸主动脉IMT与EFTh之间的关系。
我们纳入了104例(平均年龄38±11.4岁)因各种适应证接受TEE检查的患者。根据胸主动脉IMT值的中位数将患者分为两组(IMT正常组<10 mm,IMT异常组≥10 mm)。在收缩期和舒张期使用二维经胸超声心动图测量右心室游离壁的心外膜脂肪厚度。
在主动脉IMT异常组中观察到最高的心外膜脂肪厚度值(3.3±0.96 mm对4.51±0.66 mm,P<.001)。多因素线性回归分析显示,主动脉IMT与心外膜脂肪厚度独立相关(β=0.423,P<.001)。此外,在双变量分析中发现心外膜脂肪厚度与短暂性脑缺血发作史(r=0.403,P<.001)和IMT异常(r=0.643,P<.001)相关。
心外膜脂肪厚度与亚临床胸主动脉粥样硬化程度独立相关。心外膜脂肪厚度增加可能是初始动脉粥样硬化的关键标志物。