Gürdal Ahmet, Keskin Kudret, Orken Dilek N, Baran Gözde, Kiliçkesmez Kadriye
Departments of Cardiology.
Department of Neurology, Istanbul Bilim University, Istanbul, Turkey.
Neurologist. 2018 Jul;23(4):113-117. doi: 10.1097/NRL.0000000000000182.
Epicardial adipose tissue is metabolically active and is an important predictor of metabolic and cardiovascular diseases. This study investigated the echocardiographic epicardial adipose tissue measurement in young patients with embolic stroke of undetermined source (ESUS).
We studied 77 volunteers, including 40 patients with ESUS (mean age 43±8 y, 16 female patients) and 37 healthy subjects (mean age 38±7 y, 20 female subjects). All necessary biochemical parameters were analyzed, and epicardial fat thickness (EFT) was measured by echocardiography in all subjects. Additional related diagnostic work-up was conducted in each patient, according to the patients' clinical presentation.
The patients with ESUS had a significantly higher EFT than the control group (5.51±0.82 vs. 3.96±0.51; P<0.01). Furthermore, there was a positive correlation between EFT and serum C-reactive protein levels (r=0.284; P<0.05). As an optimal cut-off point, a high-risk EFT value of 4.6 mm was determined to predict ESUS, with an 87.5% sensitivity and an 81.1% specificity.
We found that echocardiographic EFT was significantly higher in young patients with ESUS than in healthy individuals. Increased EFT might be a novel risk factor in these patients.
心外膜脂肪组织具有代谢活性，是代谢性疾病和心血管疾病的重要预测指标。本研究调查了不明来源栓塞性卒中（ESUS）年轻患者的心外膜脂肪组织的超声心动图测量值。
我们研究了77名志愿者，包括40例ESUS患者（平均年龄43±8岁，16例女性患者）和37名健康受试者（平均年龄38±7岁，20例女性受试者）。分析了所有必要的生化参数，并通过超声心动图测量了所有受试者的心外膜脂肪厚度（EFT）。根据患者的临床表现，对每位患者进行了额外的相关诊断检查。
ESUS患者的EFT显著高于对照组（5.51±0.82 vs. 3.96±0.51；P<0.01）。此外，EFT与血清C反应蛋白水平呈正相关（r=0.284；P<0.05）。确定EFT的高危值为4.6mm作为预测ESUS的最佳切点，敏感性为87.5%，特异性为81.1%。
我们发现，ESUS年轻患者的超声心动图EFT显著高于健康个体。EFT增加可能是这些患者的一个新的危险因素。
