Epicardial adipose tissue density and volume are related to subclinical atherosclerosis, inflammation and major adverse cardiac events in asymptomatic subjects
Epicardial adipose tissue density and volume are related to subclinical atherosclerosis, inflammation and major adverse cardiac events in asymptomatic subjects
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DOI：
10.1016/j.jcct.2017.11.007
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发表时间：
2018-01-01
影响因子：
5.4
通讯作者：
Dey, Damini
中科院分区：
文献类型：
--
作者：
Goeller, Markus;Achenbach, Stephan;Dey, Damini
背景资料：我们研究了心外膜脂肪组织（EAT）的体积和密度是否与早期动脉粥样硬化、斑块炎症和主要不良心脏事件有关方法：对456例无症状受试者的非造影心脏CT进行EAT体积和密度的量化（年龄60.3 ± 8.3; 68% CCS > 0）。EAT体积和密度与冠状动脉钙化评分（CCS）、炎症生物标志物和MACE的关系进行了检查。结果：冠状动脉钙化受试者的EAT体积高于无钙化受试者[89 vs 74 cm（3），p < 0.001] [-76.9 vs -75.7 HU，p = 0.024]，EAT密度低于无钙化受试者[89 vs 74 cm（3），p <0.001]。EAT体积在无冠状动脉钙化的个体中最低，在早期动脉粥样硬化（CCS 1-99）[74 vs 87 cm（3），p = 0.016]和更晚期动脉粥样硬化（CCS >= 100）[89 cm（3），p = 0.002]的受试者中显著较高。EAT体积与血清派-1和MCP-1水平独立相关，与脂联素和HDL-胆固醇呈负相关（p < 0.05）。EAT密度与派-1、LDL-胆固醇呈负相关，与脂联素、sICAM-1、HDL-胆固醇呈正相关（p < 0.05）。EAT密度与MACE的相关性比EAT体积或CCS更显著[（HR 0.8，95%CI：0.7-0.98），p = 0.029]。结论：与CCS = 0的受试者相比，冠状动脉钙化的受试者的EAT体积更高，密度更低，CCS = 100的EAT体积相似< 100 and CCS >。较低的EAT密度和增加的EAT体积与冠状动脉钙化、斑块炎症标志物血清水平和MACE相关，表明功能障碍的EAT可能与早期斑块形成和炎症有关。
Background: We investigated whether epicardial adipose tissue (EAT) volume and density are related to early atherosclerosis, plaque inflammation and major adverse cardiac events (MACE, cardiac death and myocardial infarction) in asymptomatic subjects.Methods: EAT volume and density were quantified from non-contrast cardiac CT in 456 asymptomatic individuals (age 60.3 +/- 8.3; 68% with CCS > 0) from the prospective EISNER trial. EAT volume and density were examined in relation to coronary calcium score (CCS), inflammatory biomarkers and MACE.Results: EAT volume was higher and EAT density lower in subjects with coronary calcium compared to subjects without [89 vs 74 cm(3), p < 0.001] [-76.9 vs -75.7 HU, p = 0.024]. EAT volume was lowest in individuals with no coronary calcium and was significant higher in subjects with early atherosclerosis (CCS 1-99) [74 vs 87 cm(3), p = 0.016] and in subjects with more advanced atherosclerosis (CCS >= 100) [89 cm(3), p = 0.002]). EAT volume was independently related to serum levels of PAI-1, and MCP-1 and inversely related to adiponectin and HDL-cholesterol (p < 0.05). EAT density was inversely related to PAI-1 and LDL-cholesterol and positively associated to adiponectin, sICAM-1 and HDL-cholesterol (p < 0.05). EAT density was more significantly associated with MACE [(HR 0.8, 95% CI: 0.7-0.98), p = 0.029] than EAT volume or CCS.Conclusion: EAT volume was higher and density lower in subjects with coronary calcium compared to subjects with CCS = 0, with similar EAT volume in CCS < 100 and CCS >= 100. Lower EAT density and increased EAT volume were associated with coronary calcification, serum levels of plaque inflammatory markers and MACE, suggesting that dysfunctional EAT may be linked to early plaque formation and inflammation.