Epicardial Adipose Tissue Is Associated With Prevalent Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy
Epicardial Adipose Tissue Is Associated With Prevalent Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy
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DOI：
10.1536/ihj.54.297
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发表时间：
2013-09-01
影响因子：
1.5
通讯作者：
Hasebe, Naoyuki
中科院分区：
文献类型：
--
作者：
Muhib, Sharifi;Fujino, Takayuki;Hasebe, Naoyuki
肥厚型心肌病（HCM）患者中普遍存在的心房颤动（AF）是栓塞引起的卒中事件的一个重要问题，并且与高死亡率相关。心外膜脂肪组织（EAT）的增加表现出高代谢活性，可以局部影响自主神经节的活动，增强自主神经失调并增加房颤的可能性。我们检验了 EAT 与 HCM 患者中常见 AF 相关的假设。根据超声心动图检查结果和右心室活检获得的心肌组织病理学评估诊断出的 62 名特发性 HCM 患者接受了心脏磁共振成像，以评估 EAT 的范围。发生 AF 的组中 EAT 面积显着高于未发生 AF 的组。研究发现，AF 发生率的增加与 EAT 的增加显着相关，并且在调整体重指数、性别和年龄后，这种关联仍然存在。通过动态心电图测量的心率变异性的时域测量、正常与正常的标准差以及正常与正常的平均值的标准差与 EAT 面积呈负相关。 EAT与室间隔厚度、胱抑素C水平呈正相关，与24小时肌酐清除率呈负相关。 HCM 患者的 EAT 面积增加与 AF 的存在显着相关，而 AF 与基线自主神经张力、左心室质量和慢性肾脏疾病的变化有关。
Prevalent atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM) represents an important issue with regard to stroke events caused by embolization and is associated with high mortality. Increased epicardial adipose tissue (EAT), which shows high metabolic activity, can locally influence the activity of the autonomic ganglia, enhancing autonomic dysregulation and increasing the likelihood of AF. We tested the hypothesis that EAT is associated with prevalent AF in HCM patients. Sixty-two patients with idiopathic HCM diagnosed on the basis of ultrasound cardiography findings and histopathological evaluation of myocardium obtained by right ventricular biopsy underwent cardiac magnetic resonance imaging to estimate the extent of EAT. EAT area was significantly higher in the group with AF episodes than in the group without. An increased incidence of AF was found to be significantly related to an increase in EAT, and this association persisted after adjustment for body mass index, sex, and age. Time domain measures of heart rate variability measured by Holter electrocardiography, standard deviation of normal to normal, and standard deviation of the average of normal to normal were negatively related to EAT area. EAT was positively correlated with intraventricular septal thickness and cystatin C level and negatively correlated with the 24-hour creatinine clearance rate. Increased EAT area in HCM patients is significantly related to the presence of AF, which is associated with changes in baseline autonomic nervous tone, left ventricular mass, and chronic kidney disease.