Kalçık Macit, Yesin Mahmut, Güner Ahmet, Bayam Emrah, Yetim Mucahit, Doğan Tolga, Bekar Lütfü, Çelik Oğuzhan, Karavelioğlu Yusuf
Faculty of Medicine, Department of Cardiology, Hitit University, Çorum, Turkey.
Department of Cardiology, Kars Harakani State Hospital, Kars, Turkey.
Interv Med Appl Sci. 2019 Jun;11(2):106-111. doi: 10.1556/1646.11.2019.12.
Impaired coronary microcirculation, inflammation, and endothelial dysfunction were reported etiological factors for microvascular angina (MVA). Recently, increased epicardial adipose tissue (EAT) thickness has been associated with hypertension, metabolic syndrome, and coronary artery disease in general population. In this study, we aimed to evaluate the EAT thickness in patients with MVA.
This study enrolled 200 patients (83 males; mean age: 55.4 ± 8.2 years) who have been diagnosed with MVA and 200 controls (89 males; mean age: 54.4 ± 8.5 years). All patients underwent transthoracic echocardiography, and EAT thickness was measured from a parasternal long-axis view as the hypoechoic space on the right ventricular free wall.
The mean EAT thickness was significantly higher in MVA patients than the controls (5.5 ± 1.1 vs. 4.9 ± 0.7 mm; < 0.001). Multiple logistic regression analysis showed that increased EAT thickness was an independent predictor of MVA (OR = 1.183, 95% CI = 1.063-1.489; = 0.023). In receiver operating characteristic curve analyses, EAT thickness above 5.3 mm predicted MVA with a sentivity of 68% and a specificity of 63% (AUC = 0.711, 95% CI = 0.659-0.762; < 0.001).
The EAT thickness was observed significantly higher in MVA patients as compared to controls. Increased EAT thickness may be associated with mechanisms that play a major role in the pathogenesis of MVA.
冠状动脉微循环受损、炎症和内皮功能障碍被报道为微血管性心绞痛（MVA）的病因。最近，在心外膜脂肪组织（EAT）厚度增加与普通人群的高血压、代谢综合征和冠状动脉疾病相关。在本研究中，我们旨在评估MVA患者的EAT厚度。
本研究纳入了200例已诊断为MVA的患者（83例男性；平均年龄：55.4±8.2岁）和200例对照者（89例男性；平均年龄：54.4±8.5岁）。所有患者均接受经胸超声心动图检查，并从胸骨旁长轴视图测量EAT厚度，即右心室游离壁上的低回声间隙。
MVA患者的平均EAT厚度显著高于对照组（5.5±1.1对4.9±0.7mm；P<0.001）。多因素logistic回归分析显示，EAT厚度增加是MVA的独立预测因素（OR=1.183，95%CI=1.063-1.489；P=0.023）。在受试者工作特征曲线分析中，EAT厚度大于5.3mm预测MVA的敏感性为68%，特异性为63%（AUC=0.711，95%CI=0.659-0.762；P<0.001）。
与对照组相比，MVA患者的EAT厚度显著更高。EAT厚度增加可能与在MVA发病机制中起主要作用的机制有关。
