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窦性心律患者超声心动图测量的心包脂肪厚度与CHA2DS2-VASc评分之间的关系

The Relation Between Echocardiographic Epicardial Fat Thickness and CHA2DS2-VASc Score in Patients with Sinus Rhythm.

作者信息

Aksoy Fatih, Guler Serdar, Kahraman Fatih, Oskay Tülay, Varol Ercan

机构信息

Department of Cardiology, Suleyman Demirel University, Medical School, Isparta, Turkey.

出版信息

Braz J Cardiovasc Surg. 2019 Jan-Feb;34(1):41-47. doi: 10.21470/1678-9741-2018-0230.

Abstract

OBJECTIVE

To evaluate the predictive value of epicardial fat thickness (EFT) in CHA2DS2-VASc (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, age 65-74 years, sex category) score risk groups.

METHODS

A total of 158 consecutive patients (75 females, 83 males, mean age 70.8±6.3 years) admitted routinely for cardiologic control were divided into two groups according to their CHA2DS2-VASc scores (scores 0 and 1 were regarded as low risk, and score ≥2 as high risk). One hundred twenty-five of 158 patients had a high-risk score.

RESULTS

Mean EFT was significantly higher in the high-risk group than in the low-risk group (4.34±0.62 vs. 5.37±1.0; P<0.001). EFT was positively correlated with CHA2DS2-VASc score (r=0.577, P<0.001). According to receiver operating characteristics (ROC) analysis, EFT value of 4.4 mm was found to be predictive of high risk in CHA2DS2-VASc score with 80% of sensitivity and 79% of specificity (C-statistic = 0.875, P<0.001, 95% confidence interval [CI] = 0.76-0.90). And according to multivariate logistic regression analysis, EFT was an independent predictor of high thromboembolic risk in terms of CHA2DS2-VASc score.

CONCLUSION

Our findings suggest that echocardiographic EFT measurement could provide additional information on assessing cardiovascular risks, such as thromboembolic events, and individuals with increased EFT should receive more attention to reduce unfavorable cardiovascular risk factors and the development of future cardiovascular events.

摘要

目的

评估心外膜脂肪厚度(EFT)在CHA2DS2-VASc(充血性心力衰竭、高血压、年龄≥75岁、糖尿病、既往卒中或短暂性脑缺血发作、血管疾病、年龄65-74岁、性别分类)评分风险组中的预测价值。

方法

将158例因心脏疾病常规入院接受检查的连续患者(75例女性,83例男性,平均年龄70.8±6.3岁)根据CHA2DS2-VASc评分分为两组(评分0和1视为低风险,评分≥2视为高风险)。158例患者中有125例为高风险评分。

结果

高风险组的平均EFT显著高于低风险组(4.34±0.62对5.37±1.0;P<0.001)。EFT与CHA2DS2-VASc评分呈正相关(r=0.577,P<0.001)。根据受试者工作特征(ROC)分析,发现EFT值为4.4 mm可预测CHA2DS2-VASc评分中的高风险,敏感性为80%,特异性为79%(C统计量=0.875,P<0.001,95%置信区间[CI]=0.76-0.90)。并且根据多因素逻辑回归分析,就CHA2DS2-VASc评分而言,EFT是高血栓栓塞风险的独立预测因素。

结论

我们的研究结果表明,超声心动图测量EFT可为评估心血管风险(如血栓栓塞事件)提供额外信息,EFT增加的个体应受到更多关注,以减少不利的心血管危险因素和未来心血管事件的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcbf/6385825/8a1391c382a1/rbccv-34-01-0041-g01.jpg

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