心外膜脂肪组织体积是预测非缺血性心肌病患者左心室逆重构的独立指标。
Epicardial adipose tissue volume is an independent predictor of left ventricular reverse remodeling in patients with non-ischemic cardiomyopathy.
机构信息
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
Int J Cardiol. 2022 Jun 1;356:60-65. doi: 10.1016/j.ijcard.2022.03.051. Epub 2022 Mar 28.
BACKGROUND
In some patients with non-ischemic cardiomyopathy, left ventricular (LV) contraction is improved by optimal medical therapy, leading to LV reverse remodeling (RR). Patients with heart failure with improved ejection fraction and LVRR have a good prognosis, but the factors that predict RR are not fully understood. The relationship between body composition and cardiovascular disease has been reported. The present study aimed to assess the clinical predictors of LVRR in association with body composition.
METHODS
We recruited patients who were diagnosed with non-ischemic cardiomyopathy between September 2017 and January 2020. Finally, 89 patients with a reduced LV ejection fraction were enrolled in this prospective study. Body composition, including ectopic fat, was measured in all patients using computed tomography. Echocardiography was performed 6 months after enrollment to evaluate LVRR.
RESULTS
LVRR was observed in 39 patients (43.8%) after 6 months. In terms of the demographic findings, epicardial adipose tissue volume was greater in the LVRR group than in the non-LVRR group (135.2 cm [SD 128.4 cm] vs. 88.9 cm [SD 54.6 cm]; p = 0.040). The Kaplan-Meier analysis demonstrated that adverse cardiac events were significantly less frequent in the LVRR group than in the non-LVRR group (log-rank test, p = 0.013). The multivariate logistic regression analysis identified epicardial adipose tissue volume as an independent predictor of LVRR (odds ratio [OR]: 1.010, 95% confidence interval [CI]: 1.001-1.01; p = 0.036).
CONCLUSION
Epicardial adipose tissue volume is an independent predictor of LVRR in patients with non-ischemic cardiomyopathy.
背景
在一些非缺血性心肌病患者中，通过最佳药物治疗可改善左心室（LV）收缩功能，导致 LV 逆重构（RR）。射血分数改善和 LVRR 的心力衰竭患者预后良好，但预测 RR 的因素尚未完全阐明。人体成分与心血管疾病的关系已有报道。本研究旨在评估与人体成分相关的 LV 逆重构的临床预测因素。
方法
我们招募了 2017 年 9 月至 2020 年 1 月期间诊断为非缺血性心肌病的患者。最终，这项前瞻性研究纳入了 89 例 LV 射血分数降低的患者。所有患者均采用计算机断层扫描测量体成分，包括异位脂肪。入组后 6 个月行超声心动图评估 LV 逆重构。
结果
6 个月后，39 例（43.8%）患者出现 LV 逆重构。在人口统计学发现方面，RR 组的心外膜脂肪组织体积大于非 RR 组（135.2cm[SD 128.4cm]比 88.9cm[SD 54.6cm]；p=0.040）。Kaplan-Meier 分析表明，RR 组不良心脏事件发生率明显低于非 RR 组（对数秩检验，p=0.013）。多变量逻辑回归分析确定心外膜脂肪组织体积是 LV 逆重构的独立预测因素（比值比[OR]：1.010，95%置信区间[CI]：1.001-1.01；p=0.036）。
结论
心外膜脂肪组织体积是非缺血性心肌病患者 LV 逆重构的独立预测因素。
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