PDF(Pubmed)
Abstract：
Background and Objectives: This cross-sectional study conducted at the Timișoara Institute of Cardiovascular Diseases, Romania, and the Centre for Translational Research and Systems Medicine from \"Victor Babeș\" University of Medicine and Pharmacy of Timișoara, Romania, investigated the relationship between indexed epicardial adipose tissue thickness (EATTi) and oxidative stress in epicardial adipose tissue (EAT) adipocytes in the context of coronary artery disease (CAD) among open-heart surgery patients. The objective was to elucidate the contribution of EATTi as an additional marker for complexity prediction in patients with CAD, potentially influencing clinical decision-making in surgical settings. Materials and Methods: The study included 25 patients undergoing cardiac surgery, with a mean age of 65.16 years and a body mass index of 27.61 kg/m2. Oxidative stress in EAT was assessed using the ferrous iron xylenol orange oxidation spectrophotometric assay. The patients were divided into three groups: those with valvular heart disease without CAD, patients with CAD without diabetes mellitus (DM), and patients with both CAD and DM. The CAD complexity was evaluated using the SYNTAX score. Results: The EATTi showed statistically significant elevations in the patients with both CAD and DM (mean 5.27 ± 0.67 mm/m2) compared to the CAD without DM group (mean 3.78 ± 1.05 mm/m2, p = 0.024) and the valvular disease without CAD group (mean 2.67 ± 0.83 mm/m2, p = 0.001). Patients with SYNTAX scores over 32 had significantly higher EATTi (5.27 ± 0.66 mm/m2) compared to those with lower scores. An EATTi greater than 4.15 mm/m2 predicted more complex CAD (SYNTAX score >22) with 80% sensitivity and 86% specificity. The intra- and interobserver reproducibility for the EATTi measurement were excellent (intra-class correlation coefficient 0.911, inter-class correlation coefficient 0.895). Conclusions: EATTi is significantly associated with CAD complexity in patients undergoing open-heart surgery. It serves as a reliable indicator of more intricate CAD forms, as reflected by higher SYNTAX scores. These findings highlight the clinical relevance of EATTi in pre-operative assessment, suggesting its potential utility as a prognostic marker in cardiac surgical patients.
摘要：
背景和目的：这项横断面研究在蒂米什瓦拉心血管疾病研究所进行，罗马尼亚,以及蒂米什瓦拉医学与药学大学的“维克托·贝贝”转化研究和系统医学中心，罗马尼亚,研究心脏直视手术患者冠状动脉疾病（CAD）背景下心外膜脂肪组织厚度（EATTi）与心外膜脂肪组织（EAT）脂肪细胞氧化应激之间的关系。目的是阐明EATTi作为CAD患者复杂性预测的额外标记的贡献。在手术环境中可能影响临床决策。材料和方法：该研究包括25例接受心脏手术的患者，平均年龄为65.16岁，体重指数为27.61kg/m2。使用亚铁二甲酚橙氧化分光光度法评估EAT中的氧化应激。将患者分为三组：无CAD的心脏瓣膜病患者，无糖尿病（DM）的CAD患者，以及同时患有CAD和DM的患者。使用SYNTAX评分评估CAD复杂性。结果：与无DM的CAD组（平均3.78±1.05mm/m2，p=0.024）和无CAD的瓣膜疾病组（平均2.67±0.83mm/m2，p=0.001）相比，有CAD和DM的患者（平均5.27±0.67mm/m2）均有统计学意义的升高。SYNTAX评分超过32的患者的EATTi（5.27±0.66mm/m2）明显高于评分较低的患者。大于4.15mm/m2的EATTi预测更复杂的CAD(SYNTAX评分>22),具有80%的灵敏度和86%的特异性。EATTi测量的观察者内和观察者间再现性优异(类内相关系数0.911,类间相关系数0.895)。结论：EATTi与心脏直视手术患者的CAD复杂性显着相关。它可以作为更复杂的CAD形式的可靠指标，更高的语法分数反映了这一点。这些发现强调了EATTi在术前评估中的临床相关性，提示其作为心脏手术患者预后指标的潜在效用。
