摘要
目的探讨心外膜脂肪组织体积(EATV)与稳定性冠心病(SCAD)患者粥样硬化斑块负荷和成分的关系。方法纳入2016年5月至2018年10月在南京市第一医院心内科门诊行冠状动脉CT血管造影显示阳性,计划行经皮冠状动脉介入治疗的SCAD患者76例,回顾性分析其临床资料,并测定EATV。所有患者冠状动脉在支架置入前行彩色编码血管内超声(iMAP-IVUS)成像,分析斑块组织学特征。结果76例患者平均EATV为(109.17±43.34)cm^(3),根据EATV平均值将患者分为低EATV组(EATV<109.17 cm^(3),38例)和高EATV组(EATV≥109.17 cm^(3),38例)。高EATV组总管腔体积、总血管体积、总斑块体积、纤维成分体积和脂质成分体积显著高于低EATV组,差异均有统计学意义(均P<0.05)。EATV与纤维成分体积百分比之间呈显著负相关(r=–0.75,P=0.012),与坏死成分体积百分比之间呈显著正相关(r=0.68,P=0.009)。EATV与右冠状动脉(r=0.51,P=0.043)和左前降支(r=0.54,P=0.029)易损斑块有关。低密度脂蛋白胆固醇水平(β=0.16,P=0.019)和EATV(β=0.14,P=0.013)为斑块中高坏死成分体积百分比的预测因子。结论EATV增加与SCAD患者冠状动脉斑块负荷和成分有关,右冠状动脉和左前降支斑块更具易损性。
Objective To explore the relationship between epicardial adipose tissue volume(EATV)and total coronary plaque burden and composition in patients with stable coronary artery disease(SCAD).Methods The clinical data of 76 patients with SCAD who had positive coronary artery CTA angiography and were scheduled to undergo PCI in the department of cardiology in our hospital from May 2016 to October 2018 were retrospectively analyzed,and EATV was measured.iMAP-IVUS imaging was performed on all patients’coronary arteries before stent implantation to analyze the plaque histological features.Results The mean EATV was(109.17±43.34)cm^(3).According to the mean EATV,patients were divided into low EATV group(EATV<109.17 cm^(3),n=38)and high EATV group(EATV≥109.17 cm^(3),n=38).The lumen volume,total vessel volume,total plaque volume,volume of fiber component and lipid component in high EATV group were significantly higher than those in low EATV group(all P<0.05).There was a significant negative correlation between EATV and fiber components(r=–0.75,P=0.012),and a significant positive correlation between EATV and necrotic components(r=0.68,P=0.009).EATV was associated with vulnerable plaques in the left anterior descending branch(LAD)(r=0.54,P=0.029)and right coronary artery(RCA)(r=0.51,P=0.043).Multivariate analysis revealed that an increased low-density lipoprotein cholesterol level(β=0.16,P=0.019)and EATV(β=0.14,P=0.013)were independently associated with the percentage of necrotic plaque tissue.Conclusions Increased EATV was associated with the total coronary plaque burden and composition and,potentially,with the most dangerous type of plaque in the RCA and LAD.
作者
周世功
刘志忠
金国珍
刘玄德
单守杰
ZHOU Shi-gong;LIU Zhi-zhong;JIN Guo-zhen;LIU Xuan-de;SHAN Shou-jie(Department of Cardiology,Nanjing First Hospital,Nanjing 210006,China)
出处
《中国介入心脏病学杂志》
CSCD
2023年第1期44-50,共7页
Chinese Journal of Interventional Cardiology
关键词
冠心病
心外膜脂肪组织
斑块
彩色编码血管内超声
Acute coronary syndrome
Epicardial adipose tissue
Plaque
Color-coded intravascular ultrasound
