Li N, Cao Y, Li Y, Zhang K, Zhang L, Luo Q, Sun W, Shi H
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Rd., Wuhan 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
Clin Radiol. 2025 Feb;81:106760. doi: 10.1016/j.crad.2024.106760. Epub 2024 Nov 29.
To investigate the relationship between epicardial adipose tissue (EAT) and myocardial strain and the severity of coronary artery disease (CAD), and to evaluate the predictive value of EAT parameters in early left ventricular (LV) diastolic dysfunction.
One hundred seventy patients with suspected CAD who underwent both coronary computed tomography angiography and echocardiography were enrolled in 2020. LV global strains were calculated using commercial software. Epicardial adipose tissue was defined as adipose tissue between -190 HU and -30 HU in the visceral pericardium from the level of pulmonary artery bifurcation to the apical level. EAT volume and average attenuation values were measured. LV diastolic dysfunction was determined by echocardiography.
The mean age of the participants was 56.65 ± 12.64 years, and 57.65% were male. EAT volume and mean attenuation values were significantly correlated with CAD severity. EAT volume was significantly positively correlated with global longitudinal strain (GLS) (r=0.313, P<0.01), and EAT attenuation values were positively correlated with global circumferential strain and GLS (r=0.236, 0.164, respectively, both P<0.05). Age (β = 0.125, OR = 1.134, P<0.01) and EAT volume (β = 0.019, OR = 1.019, P=0.018) were independent predictors of LV diastolic dysfunction. Age combined with EAT volume improved the diagnostic efficacy of left ventricular diastolic dysfunction.
EAT parameters can reflect the severity of CAD. EAT volume is capable of predicting early LV diastolic dysfunction. Compared with GLS, EAT volume may be able to predict LV diastolic dysfunction earlier.
探讨心外膜脂肪组织（EAT）与心肌应变及冠状动脉疾病（CAD）严重程度之间的关系，并评估EAT参数对早期左心室（LV）舒张功能障碍的预测价值。
2020年纳入170例疑似CAD且接受了冠状动脉计算机断层扫描血管造影和超声心动图检查的患者。使用商业软件计算左心室整体应变。心外膜脂肪组织定义为从肺动脉分叉水平至心尖水平的心包脏层中-190 HU至-30 HU之间的脂肪组织。测量EAT体积和平均衰减值。通过超声心动图确定左心室舒张功能障碍。
参与者的平均年龄为56.65±12.64岁，男性占57.65%。EAT体积和平均衰减值与CAD严重程度显著相关。EAT体积与整体纵向应变（GLS）显著正相关（r = 0.313，P < 0.01），EAT衰减值与整体圆周应变和GLS正相关（分别为r = 0.236、0.164，均P < 0.05）。年龄（β = 0.125，OR = 1.134，P < 0.01）和EAT体积（β = 0.019，OR = 1.019，P = 0.018）是左心室舒张功能障碍的独立预测因素。年龄与EAT体积相结合可提高左心室舒张功能障碍的诊断效能。
EAT参数可反映CAD的严重程度。EAT体积能够预测早期左心室舒张功能障碍。与GLS相比，EAT体积可能能够更早地预测左心室舒张功能障碍。
