心外膜脂肪组织体积与心房颤动的相关性研究  

The correlation between epicardial adipose tissue volume and atrial fibrillation

作　　者：李雪博 舒尚志 李小宁 刘佳 王帆 田杰 李树岩[1] LI Xuebo;SHU Shangzhi;LI Xiaoning;LIU Jia;WANG Fan;TIAN Jie;LI Shuyan(Department of Cardiology,the First Hospital of Jilin University,Changchun,132000,China;Department of Cardiology,the First Affiliated Hospital of Hebei North University;Department of Cardiology,Cangzhou People's Hospital;Department of Cardiology,Hebei General Hospital;ICU,the First Affiliated Hospital of Zhejiang University)

机构地区：[1]吉林大学第一医院心内科,长春132000 [2]河北北方学院附属第一医院心内科 [3]沧州市人民医院心内科 [4]河北省人民医院心内科 [5]浙江大学医学院附属第一医院重症医学科

出　　处：《临床心血管病杂志》2019年第12期1104-1109,共6页Journal of Clinical Cardiology

基　　金：国家自然科学基金项目(No:81670044)

摘　　要：目的:通过测量窦性心律和心房颤动(房颤)患者的心外膜脂肪组织体积(EATV),探讨EATV与房颤之间的相关性。方法:选择2018-08-2019-02于吉林大学第一医院诊断为房颤同时行导管消融治疗的患者66例为房颤组,其中持续性房颤31例(持续性房颤亚组),阵发性房颤35例(阵发性房颤亚组)。以同时期行冠状动脉(冠脉)CTA排除冠心病且无房颤的患者50例为窦性心律组。所有患者均进行人体成分分析,测量出脂肪重量、体脂肪率、内脏脂肪、腰围等指标。房颤组常规行左房CTA及经食管超声检查。将左房CTA及冠脉CTA原始数据上传至工作站,利用Volume软件分析测量EATV,分析EATV与房颤的相关性。结果:房颤组EATV显著大于窦性心律组[(135.42±12.68) ml∶(113.50±13.41) ml,P<0.001];持续性房颤亚组EATV显著大于阵发性房颤亚组[(138.81±13.40) ml∶(132.43±11.37) ml,P=0.04]。相关性分析显示,房颤患者EATV与左房内径呈显著正相关(r=0.676,P<0.001)。ROC分析显示,EATV诊断房颤的曲线下面积为0.884(95%CI:0.819~0.950),最佳诊断界值为122.0 ml,敏感度、特异度分别为87.9%、74.0%。Logistic回归分析显示,EATV是房颤的独立危险因素(OR=1.087,95%CI:1.026~1.152)。结论:EATV与左房内径显著相关,EATV增大是房颤的独立危险因素。在不同类型房颤患者中,EATV差异显著。Objective:To explore the correlation between volume of epicardial adipose tissue(EATV) and atrial fibrillation by measuring EATV in patients with sinus rhythm and atrial fibrillation.Method:Sixty-six patients with atrial fibrillation and catheter ablation in the First Affiliated Hospital of Jilin University from August 2018 to February 2019 were enrolled in the atrial fibrillation group.Of whom 31 patients with persistent atrial fibrillation were enrolled in persistent atrial fibrillation subgroup,and 35 patients with paroxysmal atrial fibrillation were enrolled in paroxysmal atrial fibrillation subgroup. Other 50 patients without coronary heart disease diagnosed by CTA and without atrial fibrillation were included in sinus rhythm group.The data of fat weight,body fat percentage,visceral fat,waist circumference and other indicators in all patients were measured.Patients in atrial fibrillation group underwent left atrial CTA and esophageal ultrasonography,and the data were uploaded to the workstation to measure the EATV by using Volume software.The correlation between EATV and atrial fibrillation was analyzed.Result:The EATV in atrial fibrillation group was significantly higher than that in sinus rhythm group [(135.42±12.68) ml vs(113.50±13.41) ml,P<0.001]. The EATV in persistent atrial fibrillation subgroup was significantly higher than that in paroxysmal atrial fibrillation subgroup [(138.81±13.40) ml vs(132.43±11.37) ml,P=0.04].Correlation analysis showed that there was a significant positive correlation between EATV and left atrial diameter in patients with atrial fibrillation(r=0.676,P<0.001).ROC analysis showed that the area under the curve of EATV in diagnosis of atrial fibrillation was 0.884(95%CI:0.819-0.950),the best diagnostic threshold was 122.0 ml,and the sensitivity and specificity were 87.9% and 74.0%,respectively.Logistic regression analysis showed that EATV was an independent risk factor for atrial fibrillation(OR=1.087,95%CI:1.026-1.152).Conclusion:EATV is significantly correlated with left a

关 键 词：心房颤动 心外膜脂肪组织体积 256层螺旋CT 

分 类 号：R541.7[医药卫生—心血管疾病]