Milanese Gianluca, Silva Mario, Ledda Roberta Eufrasia, Goldoni Matteo, Nayak Sundeep, Bruno Livia, Rossi Enrica, Maffei Erica, Cademartiri Filippo, Sverzellati Nicola
Division of Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy.
Department of Medicine and Surgery, University of Parma, Parma, Italy.
Int J Cardiol. 2020 Sep 1;314:20-24. doi: 10.1016/j.ijcard.2020.04.031. Epub 2020 Apr 13.
To determine if an increased epicardial fat volume (EFV) is associated with coronary artery disease (CAD) in individuals with symptoms of cardiovascular (CV) disease.
Coronary Computed Tomographic Angiography (CCTA), demographic and clinical variables of 1344 individuals were retrieved: semi-automated measurements for EFV and coronary artery calcifications (CAC) were obtained. Individuals were grouped into three categories according to the presence of CAD, resulting in absent (CAD), non-obstructive (CAD) or obstructive (CAD) disease-groups. Relation of EFV with CAD was assessed with two approaches: 1) presence of any CAD; 2) each individual CAD category.
Median EFV was 90.52 ml (range 11.27-442.21 ml); median CAC was 56.5 (range 0-10,144); 848 individuals (63.1%) were categorized as CAD, 326 (24.3%) as CAD, 170 (12.6%) as CAD. EFV was lower in subjects without CAC (EFV = 66.5 ml), as compared to those with CAC 0.1-100 (EFV = 91.47), CAC 100.1-400 (EFV = 97.46) and CAC >400 (EFV = 109.48) (p < 0.001). EFV was lower in CAD (EFV = 87.21 ml), as compared to CAD (EFV = 93.89 ml) and CAD (EFV = 102.98 ml) individuals (p < 0.001). A logistic regression model built by including demographic and clinical variables showed inconsistent predictive value of EFV for either CAD or CAD (p > 0.05).
In the setting of symptomatic individuals, an increased amount of epicardial fat was associated with larger amount of coronary artery calcifications and was observed in individuals with obstructive CAD, however without predictive value to confidently determine CAD presence and severity.
确定心外膜脂肪体积（EFV）增加是否与有心血管（CV）疾病症状的个体的冠状动脉疾病（CAD）相关。
检索了1344名个体的冠状动脉计算机断层血管造影（CCTA）、人口统计学和临床变量：获得了EFV和冠状动脉钙化（CAC）的半自动测量值。根据CAD的存在情况将个体分为三类，形成无CAD、非阻塞性CAD或阻塞性CAD疾病组。用两种方法评估EFV与CAD的关系：1）是否存在任何CAD；2）每个个体的CAD类别。
EFV中位数为90.52毫升（范围11.27 - 442.21毫升）；CAC中位数为56.5（范围0 - 10144）；848名个体（63.1%）被归类为CAD，326名（24.3%）为CAD，170名（12.6%）为CAD。与CAC为0.1 - 100（EFV = 91.47）、CAC为100.1 - 400（EFV = 97.46）和CAC > 400（EFV = 109.48）的个体相比，无CAC的个体EFV较低（EFV = 66.5毫升）（p < 0.001）。与CAD（EFV = 93.89毫升）和CAD（EFV = 102.98毫升）个体相比，CAD个体的EFV较低（EFV = 87.21毫升）（p < 0.001）。纳入人口统计学和临床变量建立的逻辑回归模型显示，EFV对CAD或CAD的预测价值不一致（p > 0.05）。
在有症状的个体中，心外膜脂肪量增加与冠状动脉钙化量增加相关，且在阻塞性CAD个体中观察到，但对确定CAD的存在和严重程度没有可靠的预测价值。
