单位体表面积心外膜脂肪容积与房颤的相关性研究

The Correlation between Epicardial Adipose Tissue Volume Indexed to Body Surface Area and Atrial Fibrillation

目的:使用128层螺旋CT测定窦性心律和房颤患者的心外膜脂肪组织容积(EATV)并计算出单位体表面积心外膜脂肪容积(EATVI),探讨其与心房颤动之间的相关性。方法:选择本院2017年1月至2019年7月心房颤动患者76例作为房颤组,其中阵发性房颤患者45例,持续性房颤患者31例;同时入选60例窦性心律患者作为窦性心律组。136例患者均行心脏冠脉CTA成像,测量所有患者的EATV并计算出EATVI。进一步分析阵发性房颤和持续性房颤患者的测量数据,进行统计分析。结果:房颤组患者的平均EATV(138.54±25.79)mL及EATVI(72.54±23.21)显著高于窦性心律组平均EATV(107.56±21.17)mL、EATVI(53.21±19.76)差异有统计学意义(P<0.001)。持续性房颤患者的平均EATV(141.72±23.26)mL及EATVI(74.43±21.32)均大于阵发性房颤患的平均EATV(136.23±19.76)mL、EATVI(70.54±19.82),差异均无统计学意义。相关性分析显示,房颤患者EATV与EATVI呈显著正相关(r=0.971,P<0.01)。ROC曲线分析显示,EATV及EATVI诊断房颤的曲线下面积为0.877(95%CI:0.806~0.935),以113.35 mL为截断值时,敏感性和特异性分别为89.7%和72.3%;EATVI曲线下面积为0.893(95%CI:0.837~0.961)以61.15mL为截断值时,预测房颤的敏感性和特异性分别为91.6%和81.4%。Logistic多因素回归分析结果显示:EATV(OR值:1.057;95%CI:1.016~1.163)及EATVI(OR值:1.068;95%CI:1.021~1.107)均为房颤发生的独立相关危险因素。结论:采用128层螺旋CT可以客观定量测量EATV;EATV与EATVI显著相关;EATV及EATVI的增加与房颤的发生密切相关,但不同类型房颤患者之间的EATV及EATVI差异不显著。

Objective:To explore the relationship between the 128 slice spiral CT-derived epicardial adipose tissue volume indexed to body surface area(EATVI)and atrial fibrillation(AF).Methods:Seventy-six patients with atrial fibrillation in our hospital were selected as the atrial fibrillation group,including 45 patients with paroxysmal atrial fibrillation and 31 patients with persistent atrial fibrillation;60 patients with sinus rhythm were also selected as the sinus rhythm group.136 patients underwent cardiac coronary CTA imaging,measured EATV of all patients and calculated EATVI,The measurement data of patients with paroxysmal atrial fibrillation and persistent atrial fibrillation were further analyzed and statistically analyzed.Results:EATV value was significantly higher in AF group than in control group((138.54±25.79)mL vs(107.56±21.17)mL,P<0.001);EATVI value was significantly higher in AF group than in control group((72.54±23.21)vs(53.21±19.76),P<0.001).EATV((141.72±23.26)m L vs(136.23±19.76)m L)and EATVI((74.43±21.32)vs(70.54±19.82))values tended to be higher in persistent AF group than those in paroxysmal AF group(P>0.05).Correlation analysis showed that EATV and EATVI in patients with atrial fibrillation were significantly positively correlated(r=0.971,P<0.01).ROC curve analysis showed that the area under the curve of EATVI for diagnosing atrial fibrillation was 0.893(95%CI:0.837~0.961).With 61.15 ml/m^2 as the cut-off value,the sensitivity and specificity of predicting atrial fibrillation were 91.6%and 81.4%,respectively.Logistic multivariate regression analysis showed that EATVI(OR value:1.068;95%CI:1.021 to 1.107)was an independent risk factor for atrial fibrillation.Conclusion:128-slice spiral CT scan objectively and quantitatively measure EATV.EATV is significantly related to EATVI.The increase in EATVI is closely related to the occurrence of atrial fibrillation,but there is no significant difference in EATV and EATVI between patients with different types of atrial fibrillation.