PDF(Pubmed)
Abstract：
Introduction Epicardial adipose tissue (EAT) is an emerging cardiovascular biomarker. Subclinical left ventricular (LV) systolic dysfunction is common in rheumatoid arthritis (RA). The aim of this study was to assess LV systolic function using two-dimensional speckle tracking echocardiography (2D-STE) and investigate its association with EAT in RA patients without clinical cardiovascular disease (CVD). Methods 60 RA patients without manifestations of CVD and 60 age- and gender-matched healthy controls have been recruited for the study. We assessed LV systolic function and EAT in all subjects using conventional echocardiography and 2D-STE. EAT was measured as the relative echo-free region between the free wall of the right ventricle and the visceral layer of the pericardium at end-systole. Results Global longitudinal strain (GLS) was decreased and EAT was increased in the RA group compared to the control group. GLS was reduced as EAT increased in RA patients (r=-0.273, P=0.035). After adjusting for confounders, multivariate linear regression analysis revealed a weakened correlation between EAT and GLS.Age and disease activity scores28 were independent factors influencing GLS in RA. Conclusion RA patients have significantly thickened EAT compared with controls. 2D-STE can detect early LV myocardial systolic dysfunction in RA, as shown by lower GLS. Accumulation of EAT is associated with lower GLS, but older age and higher disease activity may play a greater role in LV myocardial systolic dysfunction in RA.
摘要：
引言心外膜脂肪组织(EAT)是一种新兴的心血管生物标志物。亚临床左心室（LV）收缩功能障碍在类风湿性关节炎（RA）中很常见。这项研究的目的是使用二维斑点追踪超声心动图（2D-STE）评估左心室收缩功能，并研究其与无临床心血管疾病（CVD）的RA患者的EAT的相关性。方法招募60例无CVD表现的RA患者和60例年龄和性别匹配的健康对照进行研究。我们使用常规超声心动图和2D-STE评估了所有受试者的LV收缩功能和EAT。EAT被测量为收缩末期右心室自由壁与心包内脏层之间的相对无回声区域。结果与对照组相比，RA组整体纵向应变（GLS）降低，EAT升高。RA患者GLS随EAT升高而降低(r=-0.273,P=0.035)。在调整了混杂因素后，多元线性回归分析显示EAT与GLS之间的相关性减弱。年龄和疾病活动度评分28是影响RA患者GLS的独立因素。结论RA患者与对照组相比EAT明显增厚。2D-STE可以检测RA早期左心室心肌收缩功能障碍，如较低的GLS所示。EAT的积累与较低的GLS相关，但年龄较大和疾病活动度较高可能在RA患者左心室心肌收缩功能障碍中发挥更大作用。
