急性冠脉综合征患者心外膜脂肪组织体积与左心室射血分数变化的关系

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of atherosclerosis and thrombosis Pub Date : 2025-08-05 DOI:10.5551/jat.65820

Ken Harada, Masataka Kato, Satoshi Terashima, Shinichiro Takeda, Shun Matsunaga, Takashi Kataoka, Kazuhiro Harada, Tomoyuki Nagao, Norihiro Shinoda, Nobuyuki Marui, Toyoaki Murohara

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The patients were divided into three groups according to their LVEF: heart failure with reduced EF (HFrEF), heart failure with mildly reduced EF (HFmrEF), and heart failure with preserved EF (HFpEF).Results: There was no association between the EAT volume at the onset of ACS and the difference in LVEF during follow-up (β = -0.08, p = 0.42). Peak creatine phosphokinase levels during ACS were most strongly correlated with the chronic-phase LVEF (r = -0.51, p＜0.01). Patients with HFrEF had the highest EAT volume (HFrEF: 134±38 mL; HFmrEF: 102±35 mL; HFpEF: 120±51mL; p = 0.04). Among patients with chronic HFmrEF and HFpEF, but not HFrEF, EAT volume was positively correlated with body mass index (r = 0.37, p = 0.03, and r = 0.45, p＜0.01, respectively).Conclusions: EAT volume was not associated with LVEF changes at 3 years after ACS. 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引用次数: 0

摘要

目的：虽然已有研究表明急性冠脉综合征（ACS）患者心外膜脂肪组织（EAT）体积增加，但其与ACS后左室（LV）重构和左室射血分数（LVEF）的相关性尚不清楚。本研究评估了ACS患者的EAT体积与颞叶LVEF变化之间的关系。方法：前瞻性队列研究纳入197例ACS住院患者。随访143例（男性86例，67±12岁）。超声心动图随访3年。根据患者的LVEF分为心力衰竭减少型（HFrEF）、心力衰竭轻度减少型（HFmrEF）和心力衰竭保留型（HFpEF）三组。结果：ACS发病时的EAT体积与随访时LVEF的差异无相关性（β = -0.08, p = 0.42）。ACS时肌酸磷酸激酶峰值水平与慢性期LVEF相关性最强（r = -0.51, p<0.01）。HFrEF患者的EAT体积最高(HFrEF: 134±38 mL；HFmrEF: 102±35 mL；HFpEF: 120±51毫升;P = 0.04)。在慢性HFmrEF和HFpEF患者中，进食量与体重指数呈正相关（r = 0.37, p = 0.03, r = 0.45, p<0.01）。结论：急性冠脉综合征后3年，EAT体积与LVEF变化无关。然而，慢性HFrEF患者尽管不肥胖，但其EAT体积明显更高。

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Association between Epicardial Adipose Tissue Volume and Changes in Left Ventricular Ejection Fraction in Patients with Acute Coronary Syndrome.

Aims: Although previous studies have shown that epicardial adipose tissue (EAT) volume is increased in patients with acute coronary syndrome (ACS), its correlation with left ventricular (LV) remodeling and LV ejection fraction (LVEF) after ACS remains unknown. This study evaluated the association between the EAT volume and temporal LVEF changes in patients with ACS.

Methods: This prospective cohort study included 197 patients hospitalized for ACS. Among them, 143 (86 males, 67±12 years) underwent follow-up. Echocardiography was performed for three years. The patients were divided into three groups according to their LVEF: heart failure with reduced EF (HFrEF), heart failure with mildly reduced EF (HFmrEF), and heart failure with preserved EF (HFpEF).

Results: There was no association between the EAT volume at the onset of ACS and the difference in LVEF during follow-up (β = -0.08, p = 0.42). Peak creatine phosphokinase levels during ACS were most strongly correlated with the chronic-phase LVEF (r = -0.51, p＜0.01). Patients with HFrEF had the highest EAT volume (HFrEF: 134±38 mL; HFmrEF: 102±35 mL; HFpEF: 120±51mL; p = 0.04). Among patients with chronic HFmrEF and HFpEF, but not HFrEF, EAT volume was positively correlated with body mass index (r = 0.37, p = 0.03, and r = 0.45, p＜0.01, respectively).

Conclusions: EAT volume was not associated with LVEF changes at 3 years after ACS. However, patients with chronic HFrEF had a significantly higher EAT volume despite not being obese.

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