血管内超声测量心外膜脂肪厚度与冠状动脉病变程度的相关性

目的评价血管内超声(IVUS)测量心外膜脂肪厚度(EAT)与冠状动脉病变的相关性。方法收集92例接受冠状动脉IVUS患者,应用常规超声测量EAT,并用IVUS测算冠状动脉狭窄率及斑块类型,根据检查结果将患者分为冠状动脉疾病(CAD)组和非CAD组,再根据冠状动脉狭窄率将CAD组患者分为轻度病变亚组、中度病变亚组及严重病变亚组;比较各组EAT的差异,观察EAT与冠状动脉狭窄率、斑块类型以及CAD相关危险因素之间的关系。结果 CAD组EAT值为(6.54±1.21)mm,非CAD组为(4.98±1.33)mm,二者差异有统计学意义(t=5.12,P<0.01)。随着CAD病变程度的加重,轻度、中度及严重病变亚组间EAT值逐渐升高,两两比较差异均有统计学意义(P均<0.05)。软斑块亚组EAT较钙化斑块亚组(7.16±1.00)mm vs(5.34±1.40)mm,F=0.085,P<0.05]及混合斑块亚组(6.20±1.95)mm,F=0.005,P<0.01]明显升高。EAT是CAD的独立危险因子(Wald值5.057,P=0.028)。结论超声测量EAT与冠状动脉病变严重程度具有相关性,可用于CAD患者的筛查。

Relationship between intravascular ultrasonic measurement of echocardiographic epicardial adipose thickness and coronary artery disease

Objective To observe the relationship between echocardiographic epicardial adipose thickness (EAT) measured by intravascular ultrasonography (IVUS) and the presence and severity of coronary artery disease (CAD). Methods A total of 92 patients underwent IVUS of coronary arteries, EAT was measured by 2D echocardiographic parasternal, and the area stenosis rate of coronary artery and the types of plaques were examined by IVUS. Patients were divided into CAD group and normal coronary group according to the results of IVUS, and then patients in CAD group were classified into three subgroups, including mild, medium and severe pathological change subgroups according to the area stenosis rate of coronary artery. EAT in different groups were compared. The relation between EAT and the area stenosis rate of coronary artery, the types of plaques, and risk factors of CAD were observed. Results The thickness of EAT was significantly higher in CAD group than in control group (6.54±1.21]mm vs 4.98±1.33]mm, t=5.12, P<0.01). Furthermore, the thickness of EAT in mild, medium and severe groups increased gradually with the severity of CAD (all P<0.05). The thickness of EAT in soft plaque subgroup was thicker than in calcified plaque subgroup (7.16±1.00]mm vs 5.34±1.40]mm, F=0.085, P<0.05) and mixed plaque subgroup (6.20±1.95]mm, F=0.005, P<0.01).The thickness of EAT was independent risk factor for CAD (Wald was 5.057, P=0.028). Conclusion The thickness of EAT measured by IVUS is correlated with the severity of CAD, and can be used for screening CAD.