左心房心外膜脂肪组织CT密度与心房颤动的相关性研究  

The correlation of the CT density of left atrial epicardial adipose tissue and atrial fibrillation

作　　者：李珊珊 马少卫[1] 周可[1] 侯阳[1] LI Shan-shan;MA Shao-wei;ZHOU Ke;HOU Yang(Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2021年第9期627-631,668,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨MSCT测量的左心房心外膜脂肪组织(LA-EAT)密度与心房颤动(房颤)的相关性。方法:选取2018年1月—2020年4月于中国医科大学附属盛京医院行左心房增强CTA或冠状动脉增强CTA的阵发性房颤患者44例,持续性房颤患者31例,另选取窦性心律患者112例作为对照。测量所有患者的LA-EAT CT值、心外膜脂肪组织体积(EATV),并收集一般资料。比较3组患者之间的LA-EAT CT值、EATV及相关资料的差异;采用Logistic回归分析LA-EAT CT值是否是房颤发生的危险因素;通过操作者工作特征(ROC)曲线比较LA-EAT CT值与其他指标预测房颤的价值。结果:阵发性房颤组、持续性房颤组的LA-EAT CT值均高于窦性心律组[(-109.9±5.9)HU vs (-114.6±4.1)HU,P<0.001];(-110.5±7.0)HU vs(-114.6±4.1)HU,P<0.001],持续性房颤组与阵发性房颤组的LA-EAT CT值差异无统计学意义。LA-EAT CT值、EATV、左心房直径(LAD)是房颤发生的独立危险因素(P<0.001)。LA-EAT CT值、EATV、LAD及其三者联合指标预测房颤发生的曲线下面积分别为0.740、0.724、0.750、0.861。结论:LA-EAT密度的增加与房颤的发生显著相关,LA-EAT密度是房颤发生的独立危险因素之一,LA-EAT密度与EATV、LAD联合可增加房颤发生的预测价值。Objective: To evaluate the association between multi-slice spiral computed tomography(CT)-derived left atrial epicardial adipose tissue(LA-EAT) density and atrial fibrillation(AF). Methods: Forty-four patients of paroxysmal AF and 31 patients of persistent AF in Shengjing Hospital of China Medical University from March January 2018 to April 2020 were enrolled. Fifty participants of sinus rhythm were chosen as control. 256-slice spiral CT was applied in all the participants.LA-EAT density and epicardial adipose tissue volume(EATV) in all the participants were measured, and general data was collected. LA-EAT density, EATV and related data were compared in paroxysmal AF group, persistent AF group and control group. Logistic regression analysis was used to analyze whether LA-EAT density is an independent risk factor for the presence of AF. The receiver-operating characteristic(ROC) curves of LA-EAT density and other indicators were drawn to predict the incidence of AF. Results: The LA-EAT density was significantly larger in paroxysmal AF and persistent AF group compared to that of control group, [(114.6 ±4.1)HU vs(114.6 ±4.1)HU, P <0.001 and(109.9 ±5.9)HU vs(114.6 ±4.1)HU, P <0.001]. There was no significant difference in LA-EAT density between persistent AF group and paroxysmal AF group(P >0.05). LA-EAT density, EATV, and left atrial diameter(LAD) were independent risk factors of AF(P<0.001). The area under the curve(AUC) of LA-EAT density, EATV, LAD and their combined indicator were 0.740, 0.724, 0.750 and 0.861 on prediction of the incidence of AF. Conclusion: The increase of LA-EAT density was significantly correlated with the presence of AF and was one of the independent risk factors for the presence of AF. The combined indicator of LA-EAT density and EATV and LAD could increase the predictive value of AF incidence.

关 键 词：心房颤动 心包 体层摄影术 螺旋计算机 

分 类 号：R541.75[医药卫生—心血管疾病] R814.42[医药卫生—内科学]