不同区域的心包脂肪容积与心血管危险因素及冠状动脉粥样硬化的关系

Epicardial,Paracardial and Pericardial Fat Volume by CCTA:Relationship with Cardiovascular Risk Factors and Coronary Atherosclerosis

目的 研究不同区域心包脂肪容积与心血管危险因素及冠状动脉粥样硬化的关系.方法 回顾性收集本院2018年1—12月行CT冠状动脉造影检查的住院患者资料,根据排除标准最终纳入203例.设置CT值为-200--30 HU,测量从左心耳上缘到心尖水平的心包内脂肪容积(Epi-FV)、心包外脂肪容积(Para-FV)及心脏周围脂肪容积(Peri-FV).根据测得的心包脂肪量,将Epi-FV、Para-FV及Peri-FV分别分为高低两组,即H-epi、L-epi、H-para、L-para和H-peri、L-peri组,比较不同心包脂肪分组间性别、年龄、体重指数和血糖等心血管危险因素及冠状动脉粥样硬化是否有差异.结果 H-epi、H-para及H-peri组糖尿病及高血脂患者较多,年龄较大,体重指数及甘油三酯较高,而高密度脂蛋白较低,此外,H-para及H-peri组具有更多的男性、吸烟者及更高的血糖水平.在冠状动脉粥样硬化分析中,H-epi及H-peri组有更多的冠状动脉粥样硬化患者,且斑块累及节段更广,Gensini评分更高,而H-para组危险斑块多于L-para组(所有P<0.05).结论 心脏周围不同区域的心包脂肪与心血管危险因素及冠状动脉粥样硬化的关系不同.Para-FV较高者存在更多的心血管危险因素及更多的危险斑块,而Epi-FV较高者,冠状动脉更易形成斑块,且累及范围更广.

Objective To analyze the relation of epicardial,paracardial and pericardial fat volume with cardiovascular risk factors and coronary atherosclerosis.Methods Clinical data of admitted patients undergoing coronary computed tomography angiography(CCTA)from Jan to Dec,2018 were collected,and according to exclusion criteria,203 patients were enrolled.The epicardial fat volume(Epi-FV),paracardial fat volume(Para-FV)and pericardial fat volume(Peri-FV)from the superior border of left atrial appendage to the apex with CT value between-200 HU and-30 HU were calculated according to CCTA images.Based on the quantity of fat volume,we divided the patients into different groups,including H-epi,L-epi,H-para,L-para,H-peri and L-peri,respectively.It is compared that the differences of cardiovascular risk factors,like sex,age,BMI,fasting blood glucose and so on,and coronary atherosclerosis between different groups.Results There were much more diabetes mellitus and hyperlipidemia patients in the H-epi,H-para and H-peri groups,who were older and had a higher BMI,triglyceride but a lower high-density lipoprotein level.Furthermore,groups of H-para and H-peri were consisted with more men,smoker and had a higher blood glucose concentration.In addition,the patients with greater Epi-FV and Peri-FV had more coronary atherosclerosis individuals,and more coronary artery segments involved and higher Gensini score.However,H-para group had more vulnerable plaques than L-para group(all P<0.05).Conclusion Adipose tissue around the heart in different location played different roles in coronary atherosclerosis and had different associations with cardiovascular risk factors.Greater Para-FV had more risk factors and more vulnerable coronary plaques.However,higher Epi-FV was more prone to forming coronary plaques and had a wider coronary atherosclerosis.