Al-Talabany Shaween, Mordi Ify, Graeme Houston J, Colhoun Helen M, Weir-McCall Jonathan R, Matthew Shona Z, Looker Helen C, Levin Daniel, Belch Jill J F, Dove Fiona, Khan Faisel, Lang Chim C
Division of Molecular and Clinical Medicine, University of Dundee, Mailbox 2, Ninewells Hospital & Medical School, Dundee, DD1 9SY, UK.
NHS Tayside Clinical Radiology, Ninewells Hospital, Dundee, DD1 9SY, UK.
BMC Cardiovasc Disord. 2018 Feb 13;18(1):31. doi: 10.1186/s12872-018-0770-z.
Epicardial adipose tissue (EAT) is an emerging cardio-metabolic risk factor and has been shown to correlate with adverse cardiovascular (CV) outcome; however the underlying pathophysiology of this link is not well understood. The aim of this study was to evaluate the relationship between EAT and a comprehensive panel of cardiovascular risk biomarkers and pulse wave velocity (PWV) and indexed left ventricular mass (LVMI) in a cohort of patients with cardiovascular disease (CVD) and diabetes compared to controls.
One hundred forty-five participants (mean age 63.9 ± 8.1 years; 61% male) were evaluated. All patients underwent cardiovascular magnetic resonance (CMR) examination and PWV. EAT measurements from CMR were performed on the 4-chamber view. Blood samples were taken and a range of CV biomarkers was evaluated.
EAT measurements were significantly higher in the groups with CVD, with or without T2DM compared to patients without CVD or T2DM (group 1 EAT 15.9 ± 5.5 cm vs. group 4 EAT 11.8 ± 4.1 cm, p = 0.001; group 3 EAT 15.1 ± 4.3 cm vs. group 4 EAT 11.8 ± 4.1 cm, p = 0.024). EAT was independently associated with IL-6 (beta 0.2, p = 0.019). When added to clinical variables, both EAT (beta 0.16, p = 0.035) and IL-6 (beta 0.26, p = 0.003) were independently associated with PWV. EAT was significantly associated with LVMI in a univariable analysis but not when added to significant clinical variables.
In patients with cardio-metabolic disease, EAT was independently associated with PWV. EAT may be associated with CVD risk due to an increase in systemic vascular inflammation. Whether targeting EAT may reduce inflammation and/or cardiovascular risk should be evaluated in prospective studies.
心外膜脂肪组织（EAT）是一种新出现的心脏代谢危险因素，已被证明与不良心血管（CV）结局相关；然而，这种关联的潜在病理生理学尚未完全明确。本研究的目的是评估在一组心血管疾病（CVD）和糖尿病患者队列中，与对照组相比，EAT与一组全面的心血管风险生物标志物、脉搏波速度（PWV）和左心室质量指数（LVMI）之间的关系。
对145名参与者（平均年龄63.9±8.1岁；61%为男性）进行了评估。所有患者均接受了心血管磁共振（CMR）检查和PWV检测。CMR的EAT测量在四腔视图上进行。采集血样并评估一系列CV生物标志物。
与无CVD或T2DM的患者相比，有CVD（无论有无T2DM）的组中EAT测量值显著更高（第1组EAT 15.9±5.5cm vs.第4组EAT 11.8±4.1cm，p = 0.001；第3组EAT 15.1±4.3cm vs.第4组EAT 11.8±4.1cm，p = 0.024）。EAT与白细胞介素-6独立相关（β 0.2，p = 0.019）。当加入临床变量时，EAT（β 0.16，p = 0.035）和白细胞介素-6（β 0.26，p = 0.003）均与PWV独立相关。在单变量分析中，EAT与LVMI显著相关，但加入显著临床变量后则不然。
在心脏代谢疾病患者中，EAT与PWV独立相关。由于全身血管炎症增加，EAT可能与CVD风险相关。前瞻性研究应评估针对EAT是否可降低炎症和/或心血管风险。
