MSCT测量心外膜脂肪体积与零钙化积分冠心病的相关性

目的 评价应用64层MSCT所测心外膜脂肪(EAT)体积与零钙化积分(CACS)冠心病的相关性.方法 回顾性分析接受冠状动脉CTA检查的零CACS患者102例,根据CTA结果分为冠心病和非冠心病患者,记录患者性别、年龄、体质量指数(BMI)以及高血压、糖尿病和血脂代谢异常病史.采用MSCT测量EAT体积,评价EAT体积与冠心病发生的相关性.结果 102例患者中,冠心病18例(18/102,17.65%)、非冠心病84例(84/102,82.35%).零CACS冠心病患者EAT体积为(144.60±36.23)cm³,明显高于非冠心病患者 (P<0.001);EAT体积诊断零CACS冠心病的ROC曲线下面积为0.76,诊断界值为120.82 cm³,该界值下诊断敏感度为72.2%,特异度为65.5%;Logistic回归分析显示,校正心血管危险因素后,EAT体积为零CACS冠心病的独立危险因素(OR=1.02,P=0.027).结论 EAT体积与零CACS冠心病的发生有关,可作为评估零CACS冠心病风险的一个非创伤性指标.

Correlation between volume of epicardial adipose tissue measured by MSCT and coronary artery disease with zero coronary artery calcium score

Objective To explore the correlation between volume of epicardial adipose tissue (EAT) measured by 64-slice MSCT and coronary heart disease (CHD) with zero coronary artery calcium score (CACS). Methods One hundred and two patients with zero CACS who underwent coronary CTA were retrospectively studied. According to the results of CTA, 102 patients were divided into CHD group and non-CHD group. The gender, age and body mass index (BMI), clinical history of hypertension, diabetes and hyperlipemia were recorded. EAT volume was measured by 64-slice MSCT and the correlation of EAT volume and CHD was analyzed. Results There were 18 (18/102, 17.65%) cases of CHD and 84 (84/102, 82.35%) cases of non-CHD. EAT volume in CHD group was significantly higher than that in non-CHD group. The area under ROC curve for EAT volume for diagnosing CHD with zero CACS was 0.76, and the diagnostic sensitivity and specificity was 72.2% and 65.5%, with the cut off point of 120.82 cm³. After adjusting all the considered confounders, Logistic analysis showed that EAT volume was an independent risk factor for CHD with zero CACS (OR=1.02, P=0.027). Conclusion EAT volume is related to the occurrence of CHD with zero CACS, which can be used as a noninvasive index for evaluating the risk of CHD.