Epicardial Fat Tissue Thickness as a Cardiovascular Risk Marker and its Association with Microalbuminuria in Patients with Essential Hypertension

C. Kashyap, Hemanth Harish
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Abstract

Hypertension is one of the essential modifiable risk factors in causing stroke, renal disease, cardiovascular diseases, and peripheral artery disease. Epicardial fat tissue is regarded as endocrine organ and is metabolically active as it produces angiotensinogen and free fatty acids which are proinflammatory cytokines and are atherogenic. The presence of microalbuminuria has been associated with endothelial dysfunction that predisposes to cardiovascular events. The aim of this study is to determine the association of epicardial fat tissue with age, sex, serum creatinine, left ventricular (LV) mass, serum albumin, low-density lipoprotein (LDL), and triglycerides in patients with essential hypertension. One hundred patients with essential hypertension were divided into two groups each having 50 patients. Group A included urinary albumin creatinine ratio (UACR) <30 mg/g. Group B included UACR >30 mg/g. Age, body mass index, blood pressure, creatinine, urea, albumin, LDL, triglycerides, and epicardial adipose tissue thickness (EAT) were evaluated and compared between two groups. All patients underwent UACR, transthoracic echocardiography to determine EAT, LV mass, and ejection fraction. In our study, EAT ranged from 2 mm to 6.9 mm, with mean value of 3.21 mm and 5.12 mm in Groups A and B, respectively. Mean EAT values were found to be higher in Group B compared to A and was found to be statistically significant. Similarly, LDL, triglycerides, serum albumin levels, and LV mass showed significant difference among two groups. Serum albumin level in Group B was significantly reduced than the patients with normal urine albumin creatinine ratio. EAT serve as an important indicator in patients with essential hypertension to determine target organ damage and to stratify high risk group.
原发性高血压患者心外膜脂肪组织厚度作为心血管危险标志物及其与微量白蛋白尿的关系
高血压是引起中风、肾脏疾病、心血管疾病和外周动脉疾病的重要可改变危险因素之一。心外膜脂肪组织被认为是内分泌器官,代谢活跃,因为它产生血管紧张素原和游离脂肪酸,这是促炎细胞因子和动脉粥样硬化。微量白蛋白尿的存在与内皮功能障碍有关,内皮功能障碍易导致心血管事件。本研究的目的是确定原发性高血压患者心外膜脂肪组织与年龄、性别、血清肌酐、左心室(LV)质量、血清白蛋白、低密度脂蛋白(LDL)和甘油三酯的关系。100例原发性高血压患者分为两组,每组50例。A组尿白蛋白肌酐比值(UACR) 30 mg/g。评估并比较两组患者的年龄、体重指数、血压、肌酐、尿素、白蛋白、LDL、甘油三酯和心外膜脂肪组织厚度(EAT)。所有患者均行UACR、经胸超声心动图检查EAT、左室肿块和射血分数。在我们的研究中,EAT从2 mm到6.9 mm不等,A组和B组的平均值分别为3.21 mm和5.12 mm。B组平均EAT值高于A组,差异有统计学意义。同样,LDL、甘油三酯、血清白蛋白水平和左室质量在两组之间也有显著差异。B组血清白蛋白水平明显低于尿白蛋白肌酐比正常的患者。EAT是原发性高血压患者判断靶器官损害、划分高危人群的重要指标。
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