Alexander J. Küng , Iryna Dykun , Matthias Totzeck , Raluca Mincu , Lars Michel , Clemens Kill , Oliver Witzke , Jan Buer , Tienush Rassaf , Amir A. Mahabadi
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引用次数: 0
Abstract
Background
Acute COVID-19 infection frequently affects the cardiovascular system and causes acute myocardial injury. Epicardial Adipose Tissue (EAT), a visceral adipose tissue surrounding the myocardium and coronary arteries, has unique paracrine and endocrine effects, modulating the heart's inflammatory environment. Systemic inflammation stimulates TNF-α and Interleukin-6 secretion from EAT, contributing to cytokine storms and intensifying systemic responses. We aimed to determine whether EAT amount differs in patients with and without acute COVID-19 infection and myocardial injury.
Methods
This study analyzed the CoV-COR registry cohort, conducted at the University Hospital Essen, including patients with symptoms suggestive of COVID-19 infection. The infection was confirmed by PCR. EAT thickness was measured by two-dimensional TTE.
Results
A total of 296 patients (mean age 63.6 ± 17.26 years, 55.4 % male) were included. Patients with confirmed COVID-19 infection were younger, more frequently treated with antihypertensive medication, and had higher BMI and systolic blood pressures. Univariate logistic regression showed no association between EAT and myocardial injury 0.97 (0.74; 1.28, p = 0.82). A trend towards an association was observed between increasing EAT thickness and COVID-19 infection 1.25 (0.99; 1.59, p = 0.060). Adjusting for age and gender strengthened the association, with a 48 % (1.14; 1.93, p = 0.004) increased odds of COVID-19 infection per increase in EAT thickness. Multivariable regression yielded consistent effect sizes 1.47 (1.01; 2.16, p = 0.047).
Conclusion
EAT thickness is associated with the presence of an acute COVID-19 infection but not with a myocardial injury. Further research is needed to assess if systemic viral infection induces dynamic changes in EAT.
背景COVID-19急性感染经常影响心血管系统并引起急性心肌损伤。心外膜脂肪组织(EAT)是一种围绕心肌和冠状动脉的内脏脂肪组织,具有独特的旁分泌和内分泌作用,调节心脏的炎症环境。全身性炎症刺激EAT分泌TNF-α和白细胞介素-6,促进细胞因子风暴并增强全身反应。我们的目的是确定有无急性COVID-19感染和心肌损伤患者的EAT量是否不同。方法本研究分析了在埃森大学医院进行的CoV-COR登记队列,包括有COVID-19感染症状的患者。经PCR证实感染。用二维TTE测量EAT厚度。结果共纳入296例患者,平均年龄63.6±17.26岁,男性55.4%。确诊COVID-19感染的患者更年轻,更频繁地接受降压药物治疗,BMI和收缩压更高。单因素logistic回归显示EAT与心肌损伤无相关性0.97 (0.74;1.28, p = 0.82)。胃粘膜厚度增加与COVID-19感染呈相关性1.25 (0.99;1.59, p = 0.060)。对年龄和性别进行调整后,这一关联得到了强化:48% (1.14;1.93, p = 0.004)每增加EAT厚度增加COVID-19感染的几率。多变量回归得到一致的效应量1.47 (1.01;2.16, p = 0.047)。结论eat厚度与急性COVID-19感染相关,但与心肌损伤无关。需要进一步的研究来评估全身性病毒感染是否会引起EAT的动态变化。