心外膜脂肪厚度与射血分数保留性心衰风险的相关性  

Correlation between epicardial fat thickness and heart failure with preserved ejection fraction

作　　者：李中根 李凌[1] 李黎[1] 白雪洋[1] 李宇娜 录志远 张文杰 LI Zhonggen;LI Ling;LI Li;BAI Xueyang;LI Yuna;LU Zhiyuan;ZHANG Wenjie(Department of Cardiology,The First Affiliated Hospital,Zhengzhou University,Zhengzhou,450052,China)

机构地区：[1]郑州大学第一附属医院心内科,郑州450052

出　　处：《临床心血管病杂志》2022年第5期393-399,共7页Journal of Clinical Cardiology

摘　　要：目的:探讨心外膜脂肪组织(EAT)厚度与射血分数保留性心力衰竭(HFpEF)发生风险的相关性。方法:选取2019年8月—2020年8月于郑州大学第一附属医院住院治疗,且接受常规心脏磁共振检查的HFpEF患者147例,其中男66例,女81例作为HFpEF组,另选取33例患者作为正常对照组。于心脏磁共振长轴四腔心平面测量右室游离璧及左、右房室沟心外膜脂肪厚度(EFT),同时收集其余相关指标及一般基线资料。结果:HFpEF组较对照组心房颤动、高血压、高脂血症、冠心病、肥厚型心肌病患病率及NT-proBNP、肌钙蛋白I、糖化血红蛋白明显升高,差异有统计学意义(P<0.05)。HFpEF患者右室游离璧及左、右房室沟EFT、左心房容积指数、三尖瓣反流速度均高于对照组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,NT-proBNP(β=0.092,OR=1.097,95%CI:1.036~1.161,P=0.002)、左室后壁厚度(β=2.177,OR=8.309,95%CI:1.669~41.376,P=0.010)、右室游离璧EFT(β=1.900,OR=6.683,95%CI:1.034~43.199,P=0.046)是HFpEF患者的独立危险因素(P<0.05)。结论:HFpEF的患者EFT较对照组明显增厚,右室游离璧EFT是HFpEF的发生的独立危险因素。Objective: To research the correlation between the thickness of epicardial adipose tissue(EAT) and the risk of heart failure with preserved ejection fraction(HFpEF, LVEF ≥ 50%). Methods: The 147 patients with HFpEF who were hospitalized and underwent routine cardiac magnetic resonance examinations were selected in the First Affiliated Hospital of Zhengzhou University from August 2019 to August 2020. Of which 66 were males and 81 were females as HFpEF group, another 33 patients were selected as the normal control group. The right ventricular free wall EAT and left and right atrioventricular groove EAT were measured on the long-axis four-chamber heart plane of cardiac magnetic resonance. At the same time, other related indexes and general baseline data were collected. Results: Compared with the control group, the prevalence of atrial fibrillation, hypertension, hyperlipidemia, coronary heart disease, hypertrophic cardiomyopathy, NT-proBNP, troponin I, and glycosylated hemoglobin were significantly higher in the HFpEF group. The difference was statistically significant(P<0.05). The right ventricular free wall EFT, left and right atrioventricular groove EFT, left atrial volume index, and tricuspid regurgitation velocity of HFpEF patients were higher than those of the control group, and the difference was statistically significant(P<0.05). Multivariate logistic regression analysis showed that NT-proBNP(β=0.092, OR=1.097, 95%CI: 1.036-1.161, P=0.002), left ventricular posterior wall thickness(β=2.177, OR=8.309, 95%CI: 1.669-41.376, P=0.010) and right ventricular free wall EFT(β=1.900, OR=6.683, 95%CI: 1.034-43.199, P=0.046) were independent risk factors in patients with HFpEF(P<0.05). Conclusion: The EFT of patients with HFpEF is significantly thicker than that of the control group, and the EFT of right ventricular free wall is an independent risk factor for the occurrence of HFpEF.

关 键 词：射血分数保留性心衰 心外膜脂肪 心脏磁共振 

分 类 号：R541.6[医药卫生—心血管疾病]