背景:肥胖是射血分数保留的心力衰竭(HFpEF)的重要危险因素。在这项研究中,我们探索体重指数(BMI)和脂肪组织之间的关系,如内脏脂肪组织(VAT),皮下脂肪组织(SAT),和心外膜脂肪组织(EAT),关于左心室收缩功能保留的受试者的左心室(LV)结构和功能。
方法:在2020年1月至12月之间,这项回顾性研究包括749名表现出保留的左心室收缩功能并接受了经胸超声心动图和腹部计算机断层扫描的参与者。LV结构和功能变量以及EAT,VAT,使用超声心动图和计算机断层扫描评估SAT厚度。
结果:SAT下降,而增值税和饮食随着年龄的增长而逐渐增加。BMI与各种脂肪组织之间存在显著的相关性,与增值税(r=.371,p<.001)或EAT(r=.135,p<.001)相比,SAT的相关性最强(r=.491,p<.001)。然而,EAT显示出与左心室舒张末期尺寸降低的最实质性关联,左心室收缩末期内径,间隔二尖瓣环速度和增加的相对壁厚(所有p<0.05),而调整临床变量后,VAT和SAT与LV重塑和功能参数无显著相关性.
结论:EAT是影响左心室几何和功能变化的最关键的脂肪组织,与增值税或SAT相比。厚EAT与小LV室尺寸相关,同心重塑,和放松异常。
BACKGROUND: Obesity is a significant risk factor for heart failure with preserved ejection fraction (HFpEF). In this study, we explore the relationships between body mass index (BMI) and adipose tissue compartments such as visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and epicardial adipose tissue (EAT), with respect to left ventricular (LV) structure and function in subjects with preserved LV systolic function.
METHODS: Between January and December 2020, this retrospective study included 749 participants who exhibited preserved LV systolic function and underwent transthoracic echocardiography along with abdominal computed tomography. LV structural and functional variables as well as EAT, VAT, and SAT thickness were evaluated using echocardiography and computed tomography.
RESULTS: SAT decreased, while VAT and EAT progressively increased with age. There were significant correlations between BMI and various adipose tissues, with the strongest correlation observed with SAT (r = .491, p < .001) compared to VAT (r = .371, p < .001) or EAT (r = .135, p < .001). However, EAT demonstrated the most substantial association with decreased LV end-diastolic dimension, LV end-systolic dimension, and septal mitral annular velocity and increased relative wall thickness (all p < .05), while VAT and SAT did not show significant associations with LV remodeling and functional parameters after adjusting for clinical variables.
CONCLUSIONS: EAT is the most critical adipose tissue influencing LV geometric and functional changes, compared with VAT or SAT. Thick EAT is associated small LV chamber size, concentric remodeling, and relaxation abnormalities.