Nafakhi Hussein, Al-Mosawi Abdulameer A, Alkhalil Qais Q Malik
Internal Medicine Department, Medicine College University of Kufa Najaf Iraq.
Radiology Department, Medicine College University of Kufa Najaf Iraq.
Health Sci Rep. 2023 Mar 21;6(3):e1155. doi: 10.1002/hsr2.1155. eCollection 2023 Mar.
Little is known about the clinical relevance of pericardial fat volume (PFV), compared to other conventional cardiovascular risk factors, as predictors of coronary atherosclerosis severity among postmenopausal women. Our main aim was to assess the association of PFV and cardiovascular risk factors with coronary atherosclerosis burden, including occlusive coronary artery disease (CAD) (luminal stenosis >50%), coronary artery calcium score (CAC) >100, and plaque types in postmenopausal women.
Patients who had chest pain of angina and referred for 64-slice multi-detector CT (MDCT) angiography examination to exclude occlusive CAD presence were enrolled in this retrospective study.
A total of 241 women with absence of menses for more than 2 consecutive years and not taking hormone replacement therapy were enrolled in the present study. Increased PFV (OR [CI] = 1.1 [1-1.3], = 0.004), age (OR [CI] = 1.1 [1-1.4], = 0.002), and diabetes mellitus (OR [CI] = 2 [1-4], = 0.025) were significant predictors of occlusive CAD presence. Increased PFV (OR [CI] = 1.1 [1-1.4], = 0.017) and increased age (OR [CI] = 1.2 [1.1-1.4], < 0.001) were better predictors of CAC >100 than other cardiovascular risk factors. Regarding coronary plaque types, increased age (OR [CI] = 1.1 [1.1-1.3], = 0.001) showed a significant association with coronary calcified plaque presence while increased body mass index(OR [CI] = 1.2 [1-1.4], = 0.018) showed a significant association with coronary non-calcified plaque presence.
Higher PFV values showed an independent association with occlusive CAD and significant coronary calcification. This may imply that increased PFV is likely associated with the development of advanced and severe phenotype of coronary atherosclerosis among postmenopausal women with suspected CAD.
与其他传统心血管危险因素相比，绝经后女性中心包脂肪体积（PFV）作为冠状动脉粥样硬化严重程度预测指标的临床相关性鲜为人知。我们的主要目的是评估PFV和心血管危险因素与冠状动脉粥样硬化负担之间的关联，包括闭塞性冠状动脉疾病（CAD）（管腔狭窄>50%）、冠状动脉钙化积分（CAC）>100以及绝经后女性的斑块类型。
本回顾性研究纳入了因心绞痛胸痛而转诊接受64层多排探测器CT（MDCT）血管造影检查以排除闭塞性CAD存在的患者。
本研究共纳入241名连续2年以上无月经且未接受激素替代治疗的女性。PFV增加（OR[CI]=1.1[1 - 1.3]，P=0.004）、年龄增加（OR[CI]=1.1[1 - 1.4]，P=0.002）和糖尿病（OR[CI]=2[1 - 4]，P=0.025）是闭塞性CAD存在的显著预测因素。与其他心血管危险因素相比，PFV增加（OR[CI]=1.1[1 - 1.4]，P=0.017）和年龄增加（OR[CI]=1.2[1.1 - 1.4]，P<0.001）是CAC>100的更好预测因素。关于冠状动脉斑块类型，年龄增加（OR[CI]=1.1[1.1 - 1.3]，P=0.001）与冠状动脉钙化斑块存在显著相关，而体重指数增加（OR[CI]=1.2[1 - 1.4]，P=0.018）与冠状动脉非钙化斑块存在显著相关。
较高的PFV值与闭塞性CAD和显著的冠状动脉钙化存在独立关联。这可能意味着PFV增加可能与疑似CAD的绝经后女性中晚期和严重冠状动脉粥样硬化表型的发展有关。
