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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2015年第1期

页码:

27-030

栏目:

临床研究

出版日期:

2014-09-25

文章信息/Info

Title:

Association of human epicardial adipose tissue volume, inflammatory mediators with positive vascular remodeling

作者:

周亮亮¹; 宫剑滨¹; 李德闽²; 卢光明³; 陈 栋¹; 王 璟¹

(南京大学医学院临床学院、南京军区南京总医院：1.心脏内科，2.心胸外科，3.医学影像科，江苏 南京 210002)

Author(s):

ZHOU Liang-liang¹;  GONG Jian-bin¹;  LI De-min²;  LU Guang-ming³;  CHEN Dong¹;  WANG Jing¹

(1.Department of Cardiology, 2.Department of Cardiothoracic Surgery, 3.Department of Medical Imaging, General Hospital of Nanjing Command, People’s Liberation Army & Clinical School of Medical College, Nanjing University, Nanjing 21002, Jiangsu, China)

关键词:

心外膜脂肪; 冠状动脉疾病; 易损斑块; 血管重构

Keywords:

epicardial adipose tissue;  coronary heart disease;  vulnerable plaque;  positive remodeling

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的:观察分析冠心病患者心外膜脂肪体积（EATV）与血管重构类型的相关性。方法： 行64排双源CT评估冠状动脉狭窄程度并测定EATV，同期行外周血脂、胰岛素抵抗指数等检测。经数字减影血管造影（DSA）确诊冠心病患者180例。经CT血管造影（CTA)图像测定斑块重构指数(RI),根据RI将患者分为正性重构组（80例）和负性/无重构组（100例），并分析其与EATV的相关性。结果： 正性重构组的EATV显著增加［(128±42) cm3 vs.(95±25) cm3］。logistic回归分析显示EATV是影响正性重构的独立危险因素。结论： EATV是影响冠心病病变血管正性重构的独立危险因素。

Abstract:

AIM:To investigate whether epicardial adipose tissue volume (EATV) is correlated with vascular remodeling in patients presenting with coronary heart disease (CHD). METHODS: A total of 180 patients were assessed for severity of coronary artery stenosis and EATV by 64-slice dual-source cardiac computed tomography (CT) scans. One hundred eighty patients were confirmed to have CHD utilizing digital subtraction angiography (DSA) and the other 80 patients were classified as non-CHD. Vascular remodeling indices and plaque vulnerability parameters (lipid plaque volume, fibrous plaque volume, and calcified plaque volume) were measured in order to determine any significant correlations with EATV. RESULTS: Analysis of CHD patients demonstrated that EATV in patients with positive remodeling was significantly higher ［(128±42) cm3 vs.(95±25) cm3］ than the non-positive remodeling group. Logistic regression analysis indicated that EATV is an independent risk factor for positive vascular remodeling. In the CHD group, EATV was positively correlated with lipid plaque volume and negatively correlated with fibrous/calcification plaque volume (P<0.05). CONCLUSION: Epicardial adipose tissue volume (EATV) is significantly correlated with positive remodeling in coronary heart disease.

参考文献/References

[1]Puri R,Worthley MI,Nicholls SJ.Intravascular imaging of vulnerable coronary plaque:current and future concepts[J].Nat Rev Cardiol,2011,8(3):131-139.
[2]杨震坤,沈卫峰,张大东,等.冠状动脉重塑与冠心病临床表现的关系[J].中华心血管病杂志,2003,31(1):42-45.
[3]Wang J,Wang LJ,Peng YP,et al.Association of pericardial adipose tissue volume with presence and severity of coronary atherosclerosis[J].Clin Invest Med,2013,36(3):E143-E150.
[4]Mahabadi AA,Berg MH,Lehmann N,et al.Association of epicardial fat with cardiovascular risk factors and incident myocardial infarction in the general population: the Heinz Nixdorf Recall Study[J].J Am Coll Cardiol,2013,61(13):1388-1395.
[5]Falk E,Nakano M,Bentzon JF,et al.Update on acute coronary syndromes:the pathologists'view[J].Eur Heart J,2013,34(10):719-728.
[6]Pasterkamp G,Galis ZS,De Kleijn DP.Expansive arterial remodeling:location,location,location[J].Arterioscler Thromb Vasc Biol,2004,24(4):650-657.
[7] Langheim S,Dreas L,Veschini L,et al.Increased expression and secretion of resistin in epicardial adipose tissue of patients with acutecoronary syndrome[J].Am J Physiol Heart Circ Physiol,2010,298(3):H746-H753.
[8]Iacobellis G,Gao YJ,Sharma AM.Do cardiac and perivascular adipose tissue play a role in atherosclerosis[J].Curr Diab Rep,2008,8(1):20-24.
[9]Lijnen HR.Plasmin and matrix metalloproteinases in vascular remodeling[J].Thromb Haemost,2001,86(1):324-333.
[10]Galis ZS,Khatri JJ.Matrix metalloproteinases in vascular remodeling and atherogenesis: the good,the bad, and the ugly[J].Circ Res,2002,90(3):251-262.
[11]Pasterkamp G,Fitzgerald PF,De Kleijn DP.Atherosclerotic expansive remodeled plaques: a wolf in sheep’s clothing[J].J Vasc Res,2003,39(6):514-523.
[12]Varnava AM,Mills PG,Davies MJ.Relationship between coronary artery remodeling and plaque vulnerability[J].Circulation,2002,105(8):939-943.
[13]陈文强,张 运,张 梅,等.心绞痛患者血清炎性因子和斑块超声显像特征的相关性研究[J].中华医学杂志,2004,84(13):1062-1065.

备注/Memo

备注/Memo:

收稿日期：2014-03-19.
基金项目：南京军区医学科技创新重点项目资助(09Z026)；江苏省“六大人才高峰”项目资助（WS-078）；南京军区南京总医院青年基金项目资助(2009Q003)
通讯作者：王璟，副主任医师，主要从事冠心病与高血压的基础及临床研究Email：wangjing197211@sina.com
作者简介：周亮亮，硕士生Email：Zholia@126.com

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更新日期/Last Update: 2015-01-20