多层螺旋CT测量心室周心外膜脂肪体积与室性早搏的相关性

CORRELATION BETWEEN MULTI-SLICE SPIRAL CT PERIVENTRICULAR EPICARDIAL FAT VOLUME AND VENTRICULAR PREMATURE BEAT

目的通过比较不同部位心室周心外膜脂肪体积与心室肌复极化相关指标(QT、Tp-e间期及Tp-e/QT比值)的关系,探讨心室周心外膜脂肪体积与室性早搏之间的相关性。方法回顾性分析59例频发室性早搏患者临床资料,设为观察组,选取同期排除冠心病且无室性早搏的55例患者为对照组。采用320排冠状动脉CT血管造影(CCTA)测量并计算患者心室周心外膜脂肪总体积,左、右心室周心外膜脂肪体积;超声心动图测量左心室射血分数(LVEF%)及左心室舒张末径(LAD);通过心电图测量QT间期、Tp-e间期及计算Tp-e/QT。比较二组患者基线资料、不同部位心室周心外膜脂肪体积差异;采用Pearson对心室周心外膜脂肪总体积,左、右心室周心外膜脂肪体积与室性早搏进行相关性分析。结果观察组心室周心外膜总脂肪体积及左、右心室周心外膜脂肪体积均明显大于对照组,差异均有统计学意义(均P<0.001)。观察组Tpe、QT间期中位数、Tp-e/QT均明显大于对照组,差异均有统计学意义(均P<0.001)。Pearson相关分析显示心室周心外膜脂肪总体积,左、右心室周心外膜脂肪体积均与24小时室性早搏总数呈正相关。所有患者心室周心外膜总体积按四分位分组,<25%,25%~50%,50%~75%,>75%分别标定为A、B、C、D组。从A组到D组,Tp-e间期、QT间期均延长,Tp-e/QT比值增大,差异有统计学意义(P<0.001)。结论心室周心外膜脂肪体积与室性早搏明显相关,对预测室性早搏的发生有一定价值。

Objective To explore the relationship between periventricular epicardial fat volume and ventricular premature beats by comparing the relationship between periventricular epicardial fat volume and ventricular repolarization related indexes(QT,Tp-e interval and Tp-e/QT ratio).Methods The clinical data of fifty-nine patients with frequent ventricular premature beats were selected as observation group,and were retrospectively analyzed.55 patients with coronary heart disease excluded and no ventricular premature beats were selected as the control group.320-slice coronary CT angiography(CCTA)was used to measure and calculate the total periventricular epicardial fat volume,left ventricular epicardial fat,and right ventricular epicardial fat volume;measured by echocardiography Left ventricular ejection fraction(LVEF%)and left ventricular end diastolic diameter(LAD);QT interval,Tp-e interval and Tp-e/QT calculated by electrocardiogram.Compare the baseline data of the two groups of patients and the difference in the volume of periventricular epicardial fat in different parts;Pearson correlation analysis was used to explore the correlation between the total volume of periventricular epicardial fat,the volume of left and right pericardial epicardial fat and ventricular premature beats.Results The total periventricular epicardial fat volume,right pericardial epicardialfat volume,and left ventricular epicardial fat volume of the observation group were significantly larger than those of the control group,and the difference was statistically significant(P<0.001).The Tp-e,median QT interval,and Tp-e/QT of the observation group were significantly greater than those of the control group,and the difference was statistically significant(P<0.001).Pearson correlation analysis showed that the total periventricular epicardial fat volume,left and right ventricular epicardial fat volume were positively correlated with the total number of 24-hour ventricular premature beats.The total periventricular epicardial volume of all patients was divided into quartiles,<25%,25%-50%,50%-75%,>75%were calibrated as A,B,C,and D groups.The Tp-e interval,QT interval,and Tp-e/QT ratio were all prolonged from A to D,and the difference was statistically significant(P<0.001).Conclusion The periventricular epicardial fat volume is significantly related to the occurrence of ventricular premature beats,and has certain value in predicting the occurrence of ventricular premature beats.