ST段抬高型心肌梗死患者心外膜脂肪组织与炎症指标的相关性及其对房性心律失常的影响。

Correlation of epicardial adipose tissue and inflammatory indices in patients with STEMI and implications for atrial arrhythmias.

机构信息

Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

Department of Cardiology, Tongji University School of Medicine, Shanghai Tenth People's Hospital, Shanghai, China.

出版信息

Int J Cardiol. 2024 Jul 1;406:132016. doi: 10.1016/j.ijcard.2024.132016. Epub 2024 Apr 8.

DOI:10.1016/j.ijcard.2024.132016

PMID:38599466

Abstract

BACKGROUND

Epicardial adipose tissue(EAT) is associated with inflammation in previous studies but is unknown in patients with ST-segment elevation myocardial infarction(STEMI).This study investigated the correlation between epicardial fat and inflammatory cells obtained by cardiac magnetic resonance (CMR) and the effect on atrial arrhythmias in patients with STEMI.

METHODS

This was a single-center, retrospective study. We consecutively selected patients who all completed CMR after Percutaneous Coronary Intervention (PCI) from January 2019 to December 2022 and then had regular follow-ups at 1, 3, 6, 9, and 12 months. The enrolled patients were grouped according to the presence or absence of atrial arrhythmia and divided into atrial and non-atrial arrhythmia groups.

RESULTS

White blood cell, neutrophil, lymphocyte, C-reactive protein, EATV, LVES, LVED were higher in the atrial arrhythmia group than in the non-atrial arrhythmia group, and LVEF was lower than that in the non-atrial arrhythmia group (p < 0.05); EATV was significantly positively correlated with each inflammatory indices (white blood cell: r = 0.415 p < 0.001, neutrophil:r = 0.386 p < 0.001, lymphocyte:r = 0.354 p < 0.001, C-reactive protein:r = 0.414 p < 0.001); one-way logistic regression analysis showed that risk factors for atrial arrhythmias were age, heart rate, white blood cell, neutrophil, lymphocyte, C-reactive protein, EATV, LVES, LVED; multifactorial logistic regression analysis showed that neutrophil, lymphocyte, C-reactive protein, EATV, and LVES were independent risk factors for atrial arrhythmias; ROC analysis showed that the area under the curve (AUC) for neutrophil was 0.862; the AUC for lymphocyte was 1.95; and the AUC for C-reactive protein was 0.862. reactive protein was 0.852; AUC for LVES was 0.683; and AUC for EATV was 0.869.

CONCLUSION

In patients with STEMI, EAT was significantly and positively correlated with inflammatory indices; neutrophil, lymphocyte, C-reactive protein, EATV, and LVES were independent risk factors for atrial arrhythmias and had good predictive value.

摘要

背景

既往研究表明心外膜脂肪组织（EAT）与炎症有关，但在 ST 段抬高型心肌梗死（STEMI）患者中尚不清楚。本研究旨在探讨心脏磁共振（CMR）检查获得的心外膜脂肪与炎症细胞之间的相关性，并研究其对 STEMI 患者心房颤动的影响。

方法

这是一项单中心、回顾性研究。连续入选 2019 年 1 月至 2022 年 12 月于我院行经皮冠状动脉介入治疗（PCI）后完成 CMR 检查并定期于 1、3、6、9 和 12 个月随访的患者。根据是否发生心房颤动将纳入患者进行分组，并分为心房颤动组和非心房颤动组。

结果

心房颤动组的白细胞、中性粒细胞、淋巴细胞、C 反应蛋白、EATV、LVES、LVED 高于非心房颤动组，而 LVEF 低于非心房颤动组（p<0.05）；EATV 与各炎症指标呈显著正相关（白细胞：r=0.415，p<0.001；中性粒细胞：r=0.386，p<0.001；淋巴细胞：r=0.354，p<0.001；C 反应蛋白：r=0.414，p<0.001）。单因素 logistic 回归分析显示，心房颤动的危险因素为年龄、心率、白细胞、中性粒细胞、淋巴细胞、C 反应蛋白、EATV、LVES、LVED；多因素 logistic 回归分析显示，中性粒细胞、淋巴细胞、C 反应蛋白、EATV、LVES 是心房颤动的独立危险因素；ROC 分析显示，中性粒细胞的曲线下面积（AUC）为 0.862；淋巴细胞的 AUC 为 1.95；C 反应蛋白的 AUC 为 0.862。LVES 的 AUC 为 0.683；EATV 的 AUC 为 0.869。