Department of Cardiovascular Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School.
Department of Cardio-Diabetes Medicine, Institute of Biomedical Sciences, Tokushima University Graduate School.
Circ J. 2018 Apr 25;82(5):1369-1378. doi: 10.1253/circj.CJ-17-1289. Epub 2018 Mar 21.
Compared with global cardiac adiposity, the local accumulation of fat surrounding coronary arteries might have a more direct impact on coronary artery disease (CAD). Here, we compared the local epicardial adipose tissue (EAT) thickness and global cardiac adiposity volumes for predicting CAD.
A total of 197 consecutive subjects underwent 320-slice multi-detector computed tomography coronary angiography and were segregated into CAD (≥1 coronary artery branch stenosis ≥50%) and non-CAD groups. EAT thickness was measured at the right coronary artery (EAT), the left anterior descending artery (EAT), and the left circumflex artery (EAT). Although EATand EATwere similar between the 2 groups, EATwas larger in the CAD group than in the non-CAD group (5.45±2.16 mm vs. 6.86±2.19 mm, P<0.001). EAT, after correcting for confounding factors, was strongly associated with CAD (r=0.276, P<0.001) and Gensini score (r=0.239, P<0.001). On multiple regression analysis, Framingham risk score combined with EATwas a strong predictor of CAD (adjusted R=0.121; P<0.001).
The local fat thickness surrounding the LAD is a simple and useful surrogate marker for estimating the presence, severity, and extent of CAD, independent of classical cardiovascular risk factors.
相较于全球心脏脂肪蓄积，冠状动脉周围脂肪的局部堆积可能对冠状动脉疾病（CAD）有更直接的影响。在这里，我们比较了局部心外膜脂肪（EAT）厚度和整体心脏脂肪体积来预测 CAD。
共 197 例连续患者接受了 320 层多探测器 CT 冠状动脉造影检查，并分为 CAD（≥1 支冠状动脉分支狭窄≥50%）和非 CAD 组。在右冠状动脉（EAT）、左前降支（EAT）和左旋支（EAT）测量 EAT 厚度。尽管两组之间的 EAT 和 EAT 相似，但 CAD 组的 EAT 大于非 CAD 组（5.45±2.16 mm vs. 6.86±2.19 mm，P<0.001）。在校正混杂因素后，EAT 与 CAD（r=0.276，P<0.001）和 Gensini 评分（r=0.239，P<0.001）密切相关。多元回归分析显示，弗莱明汉风险评分结合 EAT 是 CAD 的强预测因子（校正 R=0.121；P<0.001）。
LAD 周围脂肪厚度是一种简单且有用的替代标志物，可用于估计 CAD 的存在、严重程度和范围，独立于传统心血管危险因素。
