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Objective Epicardial fat volume(EFV)is the risk factor of coronary heart disease(CHD)and positive remod-el of coronary artery.This study aimed to investigate the association of the unit surface area Epicardial fat volume(Epicardial fat volume indexed to the body surface area,EFVi)with the risk of coronary heart disease(CHD)and vascular remodeling. Methods A total of 208 consecutive patients with suspected CHD underwent coronary computed tomography angiography(CTA)were selected between December 2016 and December 2017 in cardiology department, Nanjing General Hospital of Nanjing Military Area Command. They were divided into CHD group(n=135)and non-CHD group(n=73). 135 CHD group patients were divided into 2 subgroups according to the type of vascular Remodeling-positive remodeling group[vascu-lar remodeling index(RI)>1.05,n=56]and non-positive remode-ling group[vascular remodeling index(RI)<1.05,n=79]. Clinical data was collected and peripheral blood lipid was detected in the same period;EFV and RI were determined by coronary CTA and software on a workstation[Syngo MMWP(VE32B)];.EFVi was calculated and the association with plate property and vascular remodelingwas explored;To investigate the risk factor of vascular remodeling Results The EFVi and EFV[(128.91±52.22)cm3,(74.12±28.77) cm3/m3]of CHD group were obviously higher than that of non-CHD group[(76.14±30.40)cm3,(45.41±16.97)cm3/m3](P<0.01). Logistic regression analysis showed that EFVi(OR=1.06,95% CI:1.02-1.10),LDL-C(OR=2.56,95% CI:1.06-6.12),EFV (OR=1.05,95% CI:1.02-1.07)were the risk factors of CHD.Compared with the positive remodeling group[(128.91±52.22)cm3, (74.12±28.77)cm3/m3]of CHD group were obviously higher than that of non-CHD group[(17.25±6.43),(38.15±10.56)μm3], the fiber volume[(23.66±9.05)μm3]and calcification volume[(182.75±46.51)μm3]were significantly higher in non-positive re-modeling group. While EFVi[(68.31±25.16)cm3/m3]was significantly lower than the positive remodeling group[(92.15±31.04) cm3/m3](P<0.05). Hypertension(OR=2.78,95% CI:1.12-6.88),TG(OR=1.96,95% CI:1.04-3.70),LDL-C(OR=3.91, 95% CI:2.58-7.51)and EFVi(OR=1.02,95% CI:1.01-1.31)were high risk factors of vascular remodeling(P<0.05). Conclusion EFVi can be used as an important predictor of coronary heart disease risk and coronary vascular positive remodeling.
ABSTRACT
Objective@#To evaluate whether epicardial fat volume (EFV) is related to coronary artery calcification in patients with chronic kidney disease(CKD).@*Method@#Multi-slice computed tomography was performed in 30 healthy subjects and 120 patients with CKD. Cross-sectional tomographic cardiac slices from base to apex were traced semi-automatically using a Volume Viewer of AW4.3 off-line workstation, and EFV was measured by assigning Hounsfield units ranging from -250 to -30 HU to fat.The coronary artery calcification score was assessed by CaScoring software. High density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) and collecting the body mass index (BMI), dialysis route, history of diabetes and coronary artery disease were used to analyze the relationship between EFV and other risk factors in patients with CKD.@*Results@#There were 60.8%(73/120) male (mean age 62.8 years) and 39.2%(47/120) female (mean age 66.6 years) in the patients cohort, 73.3%(88/120) patients had coronary artery disease, 55.8%(67/120) had diabetes, 21 patients were on peritoneal dialysis and 9 on hemodialysis. EFV was apparently higher in stage 4-5 D CKD group compared with the control group((140.03±54.71), (145.01±64.56)and (141.45±62.04) cm3 vs.(92.42±39.56)cm3, P=0.007, 0.015 and 0.001), was similar between CKD3 and control group, and EFV was significantly higher in peritoneal dialysis group than in hemodialysis group and in coronary artery disease group compared with no coronary artery disease group((140.67±70.31) cm3 vs.(105.22±61.49) cm3, P=0.002). EFV was obviously higher in diabetes group than no diabetes group((148.41±65.78) cm3 vs.(110.53±62.37) cm3, P=0.007). CACS was apparently increased in stage 3-5 CKD group compared with the control group(140.0 vs.4.3, P<0.001). (3)When the patients were divided into four groups according to the eGFR, EFV was positively associated with CACS(rs=0.539, P=0.004) in control group, and the association become more robust in patients with CKD5(rs=0.841, P<0.000 1). EFV was related to age(r=0.662, P=0.005), BMI(r=0.648, P=0.009)and HDL-C(r=-0.433, P=0.024), but not related to eGFR and LDL-C. EFV was related to CACS(r=0.427, R2=0.182 3, P<0.001). CACS was positively correlated to age and BMI (all P<0.05)and negatively correlated with eGFR(P<0.05).@*Conclusions@#Measurement of EFV may provide another useful noninvasive indicator of coronary artery calcification in CKD patients.
ABSTRACT
Objective Epicardial fat volume ( EFV) was a risk factor for coronary heart disease ( CHD) , but there is little research regarding the relationship of EFV with insulin resistance ( IR) and CHD in patients with metabolic syndrome ( MS) .The aim of the article was to explore the effect of EFV in patients with MS on CHD and IR . Methods Patients with MS treated by percutane-ous coronary angiography ( CAG) in our hospital from February 2013 to August 2013 were recruited in this study .The data of height , weight, waist circumference(WC) and hip circumference(HP) were recorded.EFV were measured by MSCT.Fasting blood samples were collected for blood biochemical test . Results EFV in patients with MS was in positive relation with IR index (IRI)(r=0.335, P<0.001) and CHD (r=0.321, P<0.05), and the correlation still remained when the influences of WC and body mass index (BMI) were excluded.Logistic regression analysis showed that EFV was an independent risk factor for CHD (P<0.05), while linear regression analysis indicated EFV , BMI and LDL-C were the risk factors for IRI .ROC curves analysis proved EFV and BMI had diag-nosis value for IRI, and the areas under curve of EFV were 0.755 and 0.679 (P<0.05) respectively. Conclusion EFV is an in-dependent risk factor for CHD and IRI in patients with MS , and EFV has an advantage over BMI in the diagnosis value of IRI .
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Objective To evaluate the influence of C-reactive protein (CRP),insulin resistance (IR) and epicardial fat volume (EFV) on the extent of coronary atherosclerosis in patients with different body mass index(BMl).Methods One hundred and three patients with coronary artery disease were involved in current study who underwent 64-slice dual source CT and percutaneous coronary angiography.Measurements of height,weight,waist circumference (WC) were recorded,and BMI was calculated.All patients were divided into obesity group (n =45) and non-obesity group (n =58) based on BMI.EFV were calculated through 64-slice dual source CT.Blood samples were collected for biochemical examination.Gensini score were adopted to quantify the severity of coronary artery stenosis.The relationship between Gensini score and EFV,CRP and homeostasis model assessment-insulin resistance(HOMA-IR) index were statistical analyzed by SPSS16.0 software.Results The level of CRP,WC,EFV and BMI in obesity group were (11.0 ± 5.8) mg/L,(96.1 ± 7.0) cm,(122.7 ± 43.3) cm3,(27.9 ± 2.9) kg/m2 respectively,significantly higher than those in non-obesity group ((6.5 ± 3.4) mg/L,(86.4 ± 7.6) cm,(92.9 ± 39.5) cm3,(22.4 ± 1.9) kg/m2) and the differences were significant (t =2.24,6.74,3.64,11.74,and P ＜ 0.05).CRP were positively correlated with EFV (r =0.404,0.364,P ＜0.05) in both obesity and non-obesity group,While HOMA-IR were only associated with BMI in obese group(r =0.322,P ＜0.05).Gensini score in non-obesity groups were positively related with EFV and CRP (r =0.358,0.315,P ＜ 0.05),while in obesity groups were positively related with EFV,CRP and HOMA-IR(r =0.348,0.297,0.384; P ＜ 0.05).The associations between Gensini score and CRP were not significant in obesity group after adjusting BMI and WC.Multiple linear regression analysis showed that EFV and diabetes mellitus were independent risk factors of patient Gensini score.Conclusion Coronary atherosclerosis is positively related with EFV and CRP in all patients.While,coronary atherosclerosis is influenced by BMI,WC and HOMA-IR in obese group.EFV is an independent risk factor of coronary atherosclerosis.