病态窦房结综合征与心外膜脂肪组织的相关性分析

Correlation of epicardial adipose tissue with sick sinus syndrome

目的 对比病态窦房结综合征患者与正常人群不同部位心外膜脂肪体积差异,探讨心外膜脂肪组织与病态窦房结综合征的关联性。方法 选择2017年1月至2018年1月于本院住院治疗的65例病态窦房结综合征患者作为研究组,同期65例在年龄、性别、体质量指数与之匹配的正常人群作为对照组。所有入选对象均记录基线资料及伴发疾病,采用冠状动脉CT测定总心外膜脂肪组织(EAT-total)体积,心室周心外膜脂肪(EAT-ventricular)体积,心房周心外膜脂肪(EAT-atrial)体积,左房周心外膜脂肪(EAT-LA)体积及右房周心外膜脂肪(EAT-RA)体积。比较2组不同部位心外膜脂肪体积差异,分析心外膜脂肪组织与病态窦房结综合征的相关性。采用SPSS统计软件进行数据分析。结果 除心室周心外膜脂肪组织外,其余区域心外膜脂肪组织在病例组中均较对照组升高[EAT-atrial,(55.3±19.6)vs(68.7±29.1)cm^3,P<0.05;EAT-LA,(31.9±11.9)vs(39.5±19.3)cm^3,P<0.05;EAT-RA,(23.4±8.7)vs(29.2±11.5)cm^3,P<0.05;EAT-total,(130.5±42.1)vs(150.5±61.2)cm^3,P<0.05]。在多因素分析中校正混杂因素后,总心房周心外膜脂肪组织体积及右心房周心外膜脂肪体积与病态窦房结综合征的发生有关(P<0.05)。结论 病态窦房结综合征患者心外膜脂肪集聚,增多的心外膜脂肪组织可能在病态窦房结综合征的发生及发展中发挥作用。

Objective To compare the difference of volume of epicardial adipose tissue (EAT) between the patients with sick sinus syndrome(SSS) and health people, and explore the correlation of EAT with the presence of SSS. Methods A total of 65 SSS patients admitted in our medical center from January 2017 to January 2018 were subjected in this study, and another 65 health individuals with matched age, sex, and body mass index (BMI) during same period served as controls. Their demographic data and comorbid conditions were collected. Coronary CT scan was performed for total EAT (EAT-total) volume, atrial EAT (EAT-atrial) volume, right atrial EAT (EAT-RA) volume, left atrial EAT (EAT-LA) volume and ventricular EAT (EAT-ventricular) volume. The obtained parameters were compared between the 2 groups, and the correlation between EAT and presence of SSS were evaluated. SPSS statistics was used to perform the statistical analysis. Results Besides EAT-ventricular volume, the other EAT volumes were significantly greater in the patients with SSS than the health controls [EAT-atrial:(68.7±29.1) vs (55.3±19.6)cm^ 3, P <0.05;EAT-LA:(39.5±19.3) vs ( 31.9±11.9 )cm^3, P <0.05;EAT-RA:(29.2±11.5) vs (23.4±8.7)cm 3, P <0.05;EAT-total:(150.5±61.2) vs (130.5±42.1)cm^3, P <0.05 ]. Multivariate linear regression analysis revealed that EAT-atrial volume and EAT-RA volume were independently associated with the presence of SSS after adjustment for possible confounding factors. Conclusion Accumulation of epicardial adipose tissue is seen in the SSS patients. The accumulation may play a role in the occurrence and development of the disease.