Epicardial fat thickness correlates with P-wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity
Epicardial fat thickness correlates with P-wave duration, left atrial size and decreased left ventricular systolic function in morbid obesity
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DOI：
10.1016/j.numecd.2017.05.009
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发表时间：
2017-08-01
影响因子：
3.9
通讯作者：
Santo, M. A.
中科院分区：
文献类型：
--
作者：
Fernandes-Cardoso, A.;Santos-Furtado, M.;Santo, M. A.
背景和目的：肥胖症患者心外膜脂肪(EF)增加，并与心房和心室肌有重要的相互作用。这种情况下的大多数证据可能会被高血压、糖尿病和血脂异常等并存疾病的存在所混淆，这些疾病在这个人群中非常常见。EF对心房重构和心功能的影响需要对没有这些并发症的病态肥胖者进行进一步的研究。方法和结果：我们前瞻性地招募了20名代谢健康的病态肥胖者和20名正常体重的对照组。12导联心电图分析最大P波时限(PWD)。二维超声心动图测量左心房内径(LAD)、左心室射血分数(LVEF)和左心室射血分数(EFT)。肥胖组最大PWD和LAD均值分别为109.55±11.52ms x89.38±11.19ms和36.12±3.46mmx31.45+/-2.64 mm，与对照组比较差异有统计学意义(p<；0.0001)。肥胖组平均左心室射血分数较低：63.15±4.25%×66.17±3.37%(p<；0.017)。肥胖组的平均EFT较高：7.72±1.60mmx3.10+/-0.85mmp<；0.0001。EFT与PWD呈正相关(r=0.7；p=0.001)，与LAD呈正相关(r=0.667；p=0.001)。EFT与LVEF呈负相关(r=0.523；p=0.001)。多元回归分析显示EFT与LAD、LVEF呈正相关。结论：在部分病态肥胖者中，EF超标对心房重构和心功能有显著影响。(C)2017年意大利糖尿病学会、意大利动脉粥样硬化研究学会、意大利人类营养学会和费德里科二世大学临床内外科。爱思唯尔出版，版权所有。
Background and Aim: Epicardial fat (EF) is increased in obesity and has important interactions with atrial and ventricular myocardium. Most of the evidence in this scenario can be confused by the presence of comorbidities such as hypertension, diabetes and dyslipidemia, which are very common in this population. The influence of EF on atrial remodeling and cardiac function demands further investigation on morbidly obese without these comorbidities.Methods and Results: We prospectively recruited 20 metabolically healthy morbidly obese and 20 normo-weights controls. The maximum P-wave duration (PWD) was analyzed by 12-lead electrocardiogram. Left atrial diameter (LAD), left ventricular ejection fraction (LVEF) and EF thickness (EFT) were evaluated by two-dimensional echocardiography. The mean of maximum PWD and LAD were significantly larger in the obese group as compared to the control group: 109.55 +/- 11.52 ms x 89.38 +/- 11.19 ms and 36.12 +/- 3.46 mm x 31.45 +/- 2.64 mm, (p < 0.0001). The mean LVEF was lower in the obese group: 63.15 +/- 4.25% x 66.17 +/- 3.37% (p < 0.017). The mean EFT was higher in the obese group: 7.72 +/- 1.60 mm x 3.10 +/- 0.85 mm (p < 0.0001). A positive correlation was found between EFT and PWD (r = 0.70; p = 0.001) and LAD (r = 0.667; p = 0.001). An inverse correlation was found between EFT and LVEF (r = 0.523; p = 0.001). In a multiple multivariate regression analysis the EFT remains correlated with LAD and LVEF.Conclusions: In a select group of morbidly obese, the excess of EF had a significant impact on atrial remodeling and cardiac function. (C) 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.