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超声心动图测量的心外膜脂肪组织(EAT)厚度与血管造影检测的冠状动脉疾病之间的关系

Relationship between Echocardiographic Epicardial Adipose Tissue (EAT) Thickness and Angiographically Detected Coronary Artery Disease.

作者信息

Bhuiyan G R, Roy G C, Siddique M A, Rahman M, Ahmed K, Nahar F

机构信息

Dr Golam Rahman Bhuiyan, Assistant Professor, Department of Medicine, Mymensingh Medical College (MMC), Mymensingh, Bangladesh.

出版信息

Mymensingh Med J. 2017 Jul;26(3):498-504.

Abstract

Epicardial adipose tissue (EAT) is a particular form of visceral adipose tissue deposited around the heart and there is growing evidence about the physiological and metabolic importance of EAT, especially in the association of cardiovascular risk profiles and the pathogenesis of atherosclerotic coronary artery disease. This observational, cross sectional study was done to determine the relationship between echocardiographic epicardial adipose tissue (EAT) thickness and coronary artery disease (CAD). Total 123 patients with established or suspected coronary artery disease admitted for coronary angiogram in the department of Cardiology of Bangabandhu Sheikh Mujib Medical University (BSMMU) from November 2010 to the end of April 2011 were included in this study. Epicardial adipose tissue (EAT) thickness measurements by echocardiography were compared with coronary angiographic findings. Echocardiographic epicardial adipose tissue (EAT) thickness was significantly higher in patients with CAD in comparison to those with normal coronary arteries (6.67±2.24mm vs. 4.61±1.62mm; p<0.001). Furthermore, EAT thickness increased with the severity of CAD (multi-vessel disease 7.99±2.12mm vs. single vessel disease 5.93±1.97mm; p<0.001). Gensini's score significantly correlated with EAT thickness (r=0.617, p<0.001). Optimum cut-off point (OCP) of epicardial adipose tissue (EAT) thickness as a predictor of angiographic CAD was 6.44mm with 45.31% sensitivity and 92.86% specificity [ROC area 0.756, p<0.001, 95%CI (0.66-0.85)]. Echocardiographic epicardial adipose tissue (EAT) thickness was significantly correlated with the presence and severity of angiographically detected coronary artery disease (CAD).

摘要

心外膜脂肪组织(EAT)是沉积在心脏周围的一种特殊形式的内脏脂肪组织,越来越多的证据表明EAT在生理和代谢方面具有重要意义,尤其是在心血管风险特征与动脉粥样硬化性冠状动脉疾病的发病机制之间的关联方面。本观察性横断面研究旨在确定超声心动图测量的心外膜脂肪组织(EAT)厚度与冠状动脉疾病(CAD)之间的关系。2010年11月至2011年4月底,在孟加拉国谢赫·穆吉布医学大学(BSMMU)心脏病学系因冠状动脉造影而收治的123例确诊或疑似冠状动脉疾病的患者纳入本研究。通过超声心动图测量的心外膜脂肪组织(EAT)厚度与冠状动脉造影结果进行比较。与冠状动脉正常的患者相比,CAD患者的超声心动图心外膜脂肪组织(EAT)厚度显著更高(6.67±2.24mm对4.61±1.62mm;p<0.001)。此外,EAT厚度随CAD严重程度增加(多支血管病变7.99±2.12mm对单支血管病变5.93±1.97mm;p<0.001)。Gensini评分与EAT厚度显著相关(r=0.617,p<0.001)。心外膜脂肪组织(EAT)厚度作为血管造影CAD预测指标的最佳切点(OCP)为6.44mm,敏感性为45.31%,特异性为92.86%[ROC曲线下面积0.756,p<0.001,95%CI(0.66-0.85)]。超声心动图心外膜脂肪组织(EAT)厚度与血管造影检测到的冠状动脉疾病(CAD)的存在和严重程度显著相关。

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