Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Cardiology, Erlangen, Germany.
Friedrich-Alexander University Erlangen-Nürnberg (FAU), Department of Cardiology, Erlangen, Germany.
Atherosclerosis. 2021 Jan;316:73-78. doi: 10.1016/j.atherosclerosis.2020.10.006. Epub 2020 Oct 10.
Higher pericoronary adipose tissue (PCAT) attenuation, a novel marker of inflammation in coronary CT angiography (CTA), has been shown to indicate increased cardiac mortality. Supplementation of eicosapentaenoic acid (EPA) has been shown to decrease cardiovascular death. Whether blood levels of n-3 fatty acids are associated with differences in PCAT attenuation is unknown.
This is a cross-sectional analysis including 64 symptomatic patients who underwent coronary CTA. PCAT attenuation was measured in Hounsfield Units (HU) around the proximal 40 mm of the right coronary artery using semi-automated software. Erythrocyte membrane fatty acid composition was analyzed using gas chromatography. Individual fatty acids were expressed as a percentage of total identified fatty acids.
The patient cohort was divided into two groups using the median PCAT attenuation of -78.1 HU (each n = 32). No differences were seen in age, sex, BMI or traditional cardiovascular risk factors (CVRF) between groups (all p > 0.05). In univariable analysis, significantly higher values of EPA (1.00% [0.78; 1.26] vs. 0.78% [0.63; 0.99]; p = 0.02) were seen in patients with lower PCAT attenuation. All other fatty acids showed no differences (all p > 0.05). Moreover, a significant negative correlation was seen between PCAT attenuation and EPA (CC: 0.38; p = 0.002). In multivariable analysis, an inverse association of EPA with PCAT attenuation existed (ß = -0.31, p = 0.017), independent of age, gender, BMI and number of CVRF (all p > 0.1).
High levels of EPA are associated with lower PCAT attenuation on coronary CTA. This may indicate a different composition of pericoronary adipose tissue, potentially caused by a lower degree of coronary inflammation.
在冠状动脉 CT 血管造影（CTA）中，较高的冠状动脉周围脂肪组织（PCAT）衰减值是炎症的一个新标志物，已被证明与增加的心脏死亡率有关。补充二十碳五烯酸（EPA）已被证明可降低心血管死亡率。血液中 n-3 脂肪酸水平是否与 PCAT 衰减值的差异有关尚不清楚。
这是一项横断面分析，纳入了 64 名接受冠状动脉 CTA 的有症状患者。使用半自动软件，在右冠状动脉近端 40mm 处的周围测量 PCAT 衰减值，以亨氏单位（HU）表示。使用气相色谱法分析红细胞膜脂肪酸组成。个体脂肪酸以总鉴定脂肪酸的百分比表示。
根据 -78.1 HU 的中位 PCAT 衰减值将患者队列分为两组（每组 n=32）。两组间的年龄、性别、BMI 或传统心血管危险因素（CVRF）无差异（均 p>0.05）。在单变量分析中，PCAT 衰减值较低的患者 EPA 值明显较高（1.00%[0.78；1.26]比 0.78%[0.63；0.99]；p=0.02）。所有其他脂肪酸均无差异（均 p>0.05）。此外，还观察到 PCAT 衰减值与 EPA 之间存在显著负相关（CC：0.38；p=0.002）。在多变量分析中，EPA 与 PCAT 衰减值之间存在反向关联（β=-0.31，p=0.017），独立于年龄、性别、BMI 和 CVRF 数量（均 p>0.1）。
高 EPA 水平与冠状动脉 CTA 上较低的 PCAT 衰减值相关。这可能表明冠状动脉周围脂肪组织的组成不同，可能是由于冠状动脉炎症程度较低所致。
