心外膜脂肪与无症状个体亚临床动脉粥样硬化的关系。

Relation Between Epicardial Fat and Subclinical Atherosclerosis in Asymptomatic Individuals.

机构信息

*Department of Cardiology, Cardiac Imaging, Prince Sultan Cardiac Center, Qassim PSCCQ †Mathematics Department, College of Science, Qassim University, Buraydah, Saudi Arabia ‡Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.

出版信息

J Thorac Imaging. 2017 Nov;32(6):378-382. doi: 10.1097/RTI.0000000000000296.

DOI:10.1097/RTI.0000000000000296

PMID:28817459

Abstract

PURPOSE

Excessive quantity of epicardial adipose tissue (EAT) is considered a risk factor for coronary artery disease (CAD). There are limited data, however, on the relationship between the quality of EAT and CAD. We investigated the association between the density and volume of EAT and subclinical CAD defined by positive coronary artery calcification (CAC), using computed tomography (CT).

MATERIALS AND METHODS

We reviewed 609 consecutive CT scans of patients with a mild to moderate risk for CAD to assess the EAT volume, which was measured manually by tracing the parietal pericardial sac on axial images. Fat density was recorded in mean Hounsfield units (HU), and CAC was measured using the Agatston method.

RESULTS

The mean patients' age was 50±11 years, and 393 (64.5%) were men. Overall, CAC was present in 135 (22%) patients, of whom 97 (72%) were men and 38 (28%) were women. The mean EAT volume and density were 65±27 cm and -87.0±3.4 HU, respectively. Patients with CAC had significantly higher EAT volume (74±27 vs. 62±26 cm, P<0.001) and lower EAT density (-88±3 vs. -87±3.4 HU, P<0.001) compared with patients without CAC. Multivariate regression analysis showed that both EAT density (hazard ratio, 0.879; 95% confidence interval, 0.817-0.946; P=0.001) and EAT volume >100 cm (hazard ratio, 1.693; 95% confidence interval, 1.256-2.999; P=0.029) predicted the presence of CAC.

CONCLUSIONS

Both the quality and quantity of EAT derived from noncontrast CT scan predict subclinical CAD, with lower density and higher volume of epicardial fat associated with higher CACs.

摘要

目的

过量的心外膜脂肪组织（EAT）被认为是冠状动脉疾病（CAD）的一个危险因素。然而，关于 EAT 质量与 CAD 之间的关系的数据有限。我们使用计算机断层扫描（CT）研究了 EAT 的密度和体积与冠状动脉钙化（CAC）阳性定义的亚临床 CAD 之间的关系。

材料和方法

我们回顾了 609 例 CAD 轻度至中度风险患者的 CT 扫描，以评估 EAT 体积，通过在轴位图像上追踪壁层心包囊来手动测量。记录脂肪密度的平均亨氏单位（HU），并用 Agatston 方法测量 CAC。

结果

患者平均年龄为 50±11 岁，393 例（64.5%）为男性。总体而言，135 例（22%）患者存在 CAC，其中 97 例（72%）为男性，38 例（28%）为女性。EAT 体积和密度分别为 65±27cm 和-87.0±3.4HU。与无 CAC 的患者相比，有 CAC 的患者的 EAT 体积明显更高（74±27 与 62±26cm，P<0.001），EAT 密度更低（-88±3 与-87±3.4HU，P<0.001）。多变量回归分析显示，EAT 密度（危险比，0.879；95%置信区间，0.817-0.946；P=0.001）和 EAT 体积>100cm（危险比，1.693；95%置信区间，1.256-2.999；P=0.029）均预测 CAC 的存在。