A Stronger Association of Epicardial Fat Volume with Non-Valvular Atrial Fibrillation Than Measures of General Obesity in Chinese Patients Undergoing Computed Tomography Coronary Angiography.
A Stronger Association of Epicardial Fat Volume with Non-Valvular Atrial Fibrillation Than Measures of General Obesity in Chinese Patients Undergoing Computed Tomography Coronary Angiography.
复制标题
在接受计算机断层扫描冠状动脉造影的中国患者中，心外膜脂肪量与非瓣膜性心房颤动的相关性比一般肥胖的相关性更强
DOI：
10.2147/dmso.s274047
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Zhang Y
中科院分区：
文献类型：
--
作者：
Zhu J;Yang Z;Chen X;Liu J;Zheng L;Zhang L;Pi J;Li G;Zhuang T;Liu C;Wang Y;Liu L;Fan L;Chan P;Tomlinson B;Li Y;Liu Z;Zhang Y
目的心房颤动（AF）与心外膜脂肪体积（EFV）的关系在不同种族中存在差异。我们评估了房颤相关的危险因素及其与中国患者心包脂肪的相关性。方法2012 - 2014年在上海东方医院接受冠状动脉CT血管造影（CCTA）的患者2042例，其中43.8%为女性，平均年龄65.0岁。通过CT测量心包脂肪储备，并通过多变量logistic回归模型评价EFV与非瓣膜性AF风险因素的相关性。结果8.5%的患者存在房颤，其中11.6%的患者合并风湿性心脏病（RHD），8.7%的患者合并其他瓣膜疾病。随着年龄的增长，RHD相关性房颤的比例下降，非瓣膜性房颤的危险因素增加。男性非瓣膜性房颤的风险因素比例显著高于女性（p=0.008），但RHD相关房颤在女性中的患病率高于男性（p=0.013）。非瓣膜性房颤患者的BMI和EFV显著高于非瓣膜性房颤患者，EFV升高更明显（p<0.001）。多变量logistic回归分析显示，在调整BMI和临床危险因素后，EFV与AF显著相关，最高EFV四分位数与AF相关，与左心房大小和阻塞性冠状动脉疾病无关。结论EFV与非瓣膜性房颤的相关性与肥胖和临床危险因素无关，尤其是EFV最高四分位数。这些发现支持了EFV与AF相关性的日益增长的认识。
Objective An association of atrial fibrillation (AF) with epicardial fat volume (EFV) varied in different ethnic groups. We evaluated the AF-related risk factors and its association with pericardial fat in Chinese patients. Methods Patients referred for coronary computed tomography angiography (CCTA) in Shanghai East Hospital during 2012 to 2014 (n=2042, 43.8% women, mean age 65.0 years) had AF and cardiovascular risk assessment. Pericardial fat depots were measured from CT and the association of EFV with non-valvular AF risk factors was evaluated by multivariate logistic regression models. Results AF was present in 8.5% of patients with 11.6% of AF patients having rheumatic heart disease (RHD) and 8.7% having other valvular diseases. With increasing age, the proportion of RHD-related AF decreased and the risk factors for non-valvular AF increased. There was a significantly higher proportion of risk factors for non-valvular AF in men than in women (p=0.008), but RHD-related AF was more prevalent in women than men (p=0.013). The patients with non-valvular AF had significantly higher BMI and EFV with more pronounced elevation of EFV (p<0.001). Multivariate logistic regression showed a significant association of EFV with AF after adjustment for BMI and clinical risk factors, and the highest EFV quartile was associated with AF independent of left atrial size and obstructive coronary artery disease. Conclusion The association of EFV with non-valvular AF in Chinese patients was independent of generalized adiposity and clinical risk factors especially in highest EFV quartile. These findings support the growing appreciation of the association of EFV with AF.