Association of Local Epicardial Adipose Tissue Depots and Left Ventricular Diastolic Performance in Patients With Preserved Left Ventricular Ejection Fraction
Association of Local Epicardial Adipose Tissue Depots and Left Ventricular Diastolic Performance in Patients With Preserved Left Ventricular Ejection Fraction
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DOI：
10.1253/circj.cj-19-0793
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发表时间：
2020-02-01
影响因子：
3.3
通讯作者：
Shimabukuro, Michio
中科院分区：
文献类型：
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作者：
Maimaituxun, Gulinu;Yamada, Hirotsugu;Shimabukuro, Michio
背景资料：尽管心外膜脂肪组织（EAT）的全容积定量是左室舒张功能障碍（LVDD）的预测因子，但局部EAT贮库与LVDD的关系尚不清楚。我们评估了当地EAT储库对左心室舒张功能参数的影响，患者保留左心室射血分数（LVEF）。方法和结果：从423例连续患者接受心脏CT血管造影，我们招募了252窦性心律和正常LVEF。使用心脏CT测量右冠状动脉（EAT（RCA））、左前降支（EAT（LAD））、左回旋支（EAT（LCX））、右心室（EAT（RV））、左心室（EAT（LV））、右心房（EAT（RA））和左心房（EAT（LA））周围的EAT体积指数（EATV/体表面积）和局部EAT厚度。在LVDD组（n=71）中，EATV指数（75 +/- 30 vs. 64 +/- 28 mL/m（2），P=0.010），EAT（LCX）（10.7 +/- 3.8与9.4 +/- 3.4 mm，P=0.008）和EAT（LV）（2.6 +/- 1.6与2.1 +/- 1.4 mm，P=0.024）大于非LVDD组（n=181）。相反，EAT（LCX）和EAT（LV）与外侧E'降低和外侧E/e'增加显著相关。多元回归分析表明，EAT（LCX）和EAT（LV）与左室舒张功能参数密切相关。结论：局部EAT库与二尖瓣环运动改变。进一步的研究是必要的，以澄清是否局部EAT仓库功能与LVDD的临床表现。
Background: Although full-volume quantification of epicardial adipose tissue (EAT) is a predictor of LV diastolic dysfunction (LVDD), how localized EAT depots are linked to LVDD remains unclear. We evaluated the effect of local EAT depots on LV diastolic function parameters in patients with preserved LV ejection fraction (LVEF).Methods and Results: From 423 consecutive patients who underwent cardiac CT angiography, we recruited 252 with sinus rhythm and normal LVEF. The EAT volume index (EATV/body surface area) and the localized EAT thickness around the right coronary artery (EAT(RCA)), left anterior descending artery (EAT(LAD)), left circumflex artery (EAT(LCX)), right ventricle (EAT(RV)), left ventricle (EAT(LV)), right atrium (EAT(RA)), and left atrium (EAT(LA)) were measured using cardiac CT. In the LVDD group (n=71), the EATV index (75 +/- 30 vs. 64 +/- 28 mL/m(2), P=0.010), EAT(LCX) (10.7 +/- 3.8 vs. 9.4 +/- 3.4 mm, P=0.008), and EAT(LV) (2.6 +/- 1.6 vs. 2.1 +/- 1.4 mm, P=0.024) were greater than in the non-LVDD group (n=181). In contrast, EAT(LCX) and EAT(LV) were markedly associated with decreased lateral e' and increased lateral E/e'. Multiple regression analysis indicated that EAT(LCX) and EAT(LV) were strongly associated with LV diastolic function parameters.Conclusions: Localized EAT depots are linked to altered mitral annular motion. Further study is warranted to clarify whether localized EAT depots are functionally linked to the clinical manifestations of LVDD.