心外膜脂肪组织体积增加可能会对接受经导管主动脉瓣植入术的患者的预后产生不利影响。
Increased epicardial adipose tissue volume may adversely affect outcomes in patients undergoing transcatheter aortic valve implantation.
作者信息
Özbek Kerem, Dağlı Mustafa, Balun Ahmet, Yigitbasi Murat M, Çetin Zehra G, Demirtaş Bekir, Çamur Eren, Çetin Mustafa, Çiçekçioğlu Hülya
机构信息
Department of Cardiology, Ankara Bilkent City Hospital, Ankara, Turkey.
Department of Radiology, Ankara Bilkent City Hospital, Ankara, Turkey.
出版信息
Postepy Kardiol Interwencyjnej. 2024 Dec;20(4):420-427. doi: 10.5114/aic.2024.142574. Epub 2024 Aug 29.
INTRODUCTION
Epicardial adipose tissue (EAT) influences the development of cardiovascular diseases through the secretion of inflammatory cytokines. Transcatheter aortic valve implantation (TAVI) is one of the most commonly used methods for treating severe aortic stenosis in adults.
AIM
Given the role of inflammatory cytokines in the progression of aortic stenosis, we investigated the impact of EAT on the outcomes of patients undergoing TAVI.
MATERIAL AND METHODS
The medical records of 334 patients who underwent TAVI for symptomatic severe aortic stenosis between March 2018 and December 2022 were evaluated after applying the exclusion criteria. Major adverse cardiac and cerebrovascular endpoints (MACCE) were defined according to the Valvular Academic Research Consortium criteria. The patients were divided into two groups: those with and without MACCE.
RESULTS
Mean EAT volume was higher in patients with MACCE than those without MACCE (120.7 ±43.9 vs. 96.1 ±39.8, < 0.001). Univariate Cox proportional-risk analysis revealed that creatinine and albumin levels, mean systolic pulmonary artery pressure, and EAT volume were significantly associated with MACCE. Multivariate Cox proportional-hazard analysis showed that EAT volume (hazard ratio (HR) = 1.012; 95% confidence interval (CI): 1.006-1.018; < 0.001) and albumin level (HR = 0.925; 95% CI: 0.866-0.987; = 0.018) were significantly independently associated with MACCE.
CONCLUSIONS
The EAT volume and 1-year outcomes may be related in patients undergoing TAVI for severe aortic stenosis.
引言
心外膜脂肪组织（EAT）通过分泌炎性细胞因子影响心血管疾病的发展。经导管主动脉瓣植入术（TAVI）是治疗成人重度主动脉瓣狭窄最常用的方法之一。
目的
鉴于炎性细胞因子在主动脉瓣狭窄进展中的作用，我们研究了EAT对接受TAVI患者预后的影响。
材料与方法
在应用排除标准后，对2018年3月至2022年12月期间因有症状的重度主动脉瓣狭窄接受TAVI的334例患者的病历进行评估。主要不良心脑血管终点（MACCE）根据瓣膜学术研究联盟标准定义。患者分为两组：发生MACCE的患者和未发生MACCE的患者。
结果
发生MACCE的患者平均EAT体积高于未发生MACCE的患者（120.7±43.9 vs. 96.1±39.8，<0.001）。单因素Cox比例风险分析显示，肌酐和白蛋白水平、平均收缩期肺动脉压和EAT体积与MACCE显著相关。多因素Cox比例风险分析表明，EAT体积（风险比（HR）=1.012；95%置信区间（CI）：1.006-1.018；<0.001）和白蛋白水平（HR = 0.925；95%CI：0.866-0.987；=0.018）与MACCE显著独立相关。
结论
对于因重度主动脉瓣狭窄接受TAVI的患者，EAT体积与1年预后可能相关。
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