Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari - Polo di Monserrato, s.s. 554 Monserrato, Cagliari 09045, Italy.
Mater Misericordiae University Hospital and Our Lady's Children's Hospital, University College of Dublin, Crumlin, Dublin, Ireland.
Eur J Radiol. 2023 Mar;160:110706. doi: 10.1016/j.ejrad.2023.110706. Epub 2023 Jan 21.
The aims of our study were to investigate with cardiovascular magnetic resonance (CMR) the role of Epicardial Fat Volume (EFV) and distribution in patients with Takotsubo cardiomyopathy (TTC). Moreover, we explored EFV in patients with TTC and related this to comorbidities, cardiac biomarkers, and cardiac function.
This retrospective study performed CMR scans in 30 consecutive TTC patients and 20 healthy controls. The absolute amount of EFV was quantified in consecutive short-axis cine stacks through the modified Simpson's rule. In addition, the left atrio-ventricular groove (LV) and right ventricle (RV) Epicardial Fat Thickness (EFT) were measured as well. Besides epicardial fat, LV myocardial strain parameters and T2 mapping measurements were obtained.
TTC patients and controls were of comparable age, sex, and body mass index. Compared to healthy controls, patients with TTC demonstrated a significantly increased EFV, epicardial fat mass, and EFV indexed for body 7surface area (p = 0.005; p = 0.003; p = 0.008; respectively). In a multiple regression model including age, sex, BMI, atrial fibrillation, and dyslipidemia, TTC remained an independent association with EFV (p = 0.008). Global T2 mapping and Global longitudinal strain in patients with TTC were correlated with EFV (r = 0.63, p = 0.001, and r = 0.44, p = 0.02, respectively).
Patients with TTC have increased EFV compared to healthy controls, despite a similar body mass index. The amount of epicardial fat was associated with CMR markers of myocardial inflammation and subclinical contractile dysfunction.
本研究旨在通过心血管磁共振（CMR）研究心外膜脂肪体积（EFV）在心尖球囊样心肌病（TTC）患者中的作用及其分布。此外，我们还探讨了 TTC 患者的 EFV 情况，并将其与合并症、心脏生物标志物和心功能相关联。
这项回顾性研究对 30 例连续 TTC 患者和 20 例健康对照者进行了 CMR 扫描。通过改良辛普森法则对连续短轴电影堆栈进行 EFV 绝对量的定量。此外，还测量了左房-室沟（LV）和右心室（RV）心外膜脂肪厚度（EFT）。除心外膜脂肪外，还获得了 LV 心肌应变参数和 T2 映射测量值。
TTC 患者和对照组的年龄、性别和体重指数相当。与健康对照组相比，TTC 患者的 EFV、心外膜脂肪质量和 EFV 与体表面积指数显著增加（p=0.005；p=0.003；p=0.008；分别）。在包括年龄、性别、BMI、房颤和血脂异常的多元回归模型中，TTC 仍然与 EFV 独立相关（p=0.008）。TTC 患者的整体 T2 映射和整体纵向应变与 EFV 相关（r=0.63，p=0.001 和 r=0.44，p=0.02，分别）。
与健康对照组相比，TTC 患者的 EFV 增加，尽管体重指数相似。心外膜脂肪的量与 CMR 标记物的心肌炎症和亚临床收缩功能障碍相关。
