The Correlation between Epicardial Adipose Tissue and Coronary Artery Atherosclerosis with the Dual-source CT
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摘要:
目的 探讨双源CT测量心周脂肪组织（pericardial adipose tissue，PAT）体积、心外膜脂肪组织（epicardial adipose tissue，EAT）体积、EAT/PAT比值，分析与冠状动脉粥样硬化程度的相关性。 方法 收集223例临床怀疑冠心病患者，所有患者均行双源CT冠状动脉造影检查。应用Circulation软件评价冠状动脉病变情况。分析PAT体积、EAT体积、EAT/PAT比值与性别，有、无冠状动脉粥样硬化及冠状动脉粥样硬化程度的相关性。 结果 有、无冠状动脉硬化组，PAT体积、EAT体积均无性别差异（P > 0.05），EAT/PAT比值存在性别差异（P < 0.05）。男、女性PAT体积、EAT体积、EAT/PAT比值与有、无冠状动脉粥样硬化成正相关（P < 0.05）；所有患者PAT体积、EAT体积、EAT/PAT比值与有、无冠状动脉粥样硬化均成正相关（P < 0.05）。 结论 EAT体积较PAT体积与CAS相关性更高，而EAT/PAT较PAT体积、EAT体积与CAS具有更高的相关性，应能更准确地预测CHD。 Abstract:Objective To explore the correlation between adipose tissue around the heart （pericardial adipose tissue, PAT; epicardial adipose tissue, EAT） and severity of coronary artery atherosclerosis with the Dual-source CT. Methods 223 patients suspected with coronary artery disease underwent Dual-source CT coronary angiography were enrolled in this study. The severity of coronary artery atherosclerosis were evaluated by using Circulation software. The correlation between PAT volume, EAT volume, EAT/PAT ratio and gender, with or without coronary atherosclerosis and the degree of coronary atherosclerosis were analyzed. Results There was no gender difference in PAT volume and EAT volume between the two groups （P > 0.05）, and there was gender difference in EAT/PAT ratio between the two groups （P < 0.05）. PAT volume, EAT volume and EAT/PAT ratio were positively correlated with coronary atherosclerosis in males and females （P < 0.05）. PAT volume, EAT volume and EAT/PAT ratio were positively correlated with the presence and absence of coronary atherosclerosis in all patients （P < 0.05）. Conclusion The correlation between EAT volume and CAS is higher than PAT volume, while the ratio of EAT/PAT has higher correlation with CAS than PAT volume and EAT volume, which should be able to predict CHD more accurately. -
表 1 不同性别冠状动脉粥样硬化组心脏周围脂肪组织比较[（
$M \pm Q $ ）mm3]Table 1. Comparison of pericardial adipose tissue in different genders of patients with coronary atherosclerosis [（
$M \pm Q $ ）mm3]变量 性别 n M ± Q Z P PAT 男 70 193.56 ± 107.01 −0.099 0.256 女 63 182.77 ± 92.94 EAT 男 70 106.05 ± 58.58 0.022 0.799 女 63 119.8 ± 64.73 EAT/PAT 男 70 0.57 ± 0.09 0.402 < 0.001* 女 63 0.64 ± 0.1 *P < 0.05。 
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表 2 不同性别无冠状动脉粥样硬化心脏周围脂肪组织比较[（
$M \pm Q $ ）mm3]Table 2. Comparison of pericardial adipose tissue in different genders of patients without coronary atherosclerosis [（
$M \pm Q $ ）mm3]变量 性别 n M ± Q Z P PAT 男 43 155.28 ± 102.44 −0.171 0.107 女 47 125.96 ± 107.3 EAT 男 43 80.86 ± 45.67 −0.075 0.485 女 47 75.22 ± 62.22 EAT/PAT 男 43 0.53 ± 0.07 0.355 0.001* 女 47 0.58 ± 0.07 *P < 0.05。
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表 3 男性有、无冠状动脉粥样硬化组心脏周围脂肪组织比较[（
$M \pm Q $ ）mm3]Table 3. Comparison of pericardial adipose tissue between male patients with or without coronary atherosclerosis [（
$M \pm Q $ ）mm3]变量 有无冠脉硬化 n M ± Q Z P PAT 有 70 193.55 ± 107.01 0.204 0.031 无 43 155.28 ± 102.44 EAT 有 70 106.5 ± 58.58 0.281 0.003* 无 43 80.86 ± 45.67 EAT/PAT 有 70 0.57 ± 0.09 0.276 0.003* 无 43 0.53 ± 0.07 *P < 0.05。
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表 4 女性有、无冠状动脉粥样硬化组心脏周围脂肪组织比较[（
$M \pm Q $ ）mm3]Table 4. Comparison of pericardial adipose tissue between female patients with or without coronary atherosclerosis [（
$M \pm Q $ ）mm3]变量 有无冠脉硬化 n M ± Q Z P PAT 有 63 182.77 ± 92.94 0.295 0.002* 无 47 125.96 ± 107.3 EAT 有 63 119.8 ± 64.73 0.372 < 0.001* 无 47 75.22 ± 62.22 EAT/PAT 有 63 0.64 ± 0.1 0.393 < 0.001* 无 47 0.58 ± 0.07 *P < 0.05。
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表 5 有、无冠状动脉粥样硬化组心脏周围脂肪组织比较[（
$M \pm Q $ ）mm3]Table 5. Comparison of pericardial adipose tissue in patients with or without coronary atherosclerosis [（
$M \pm Q $ ）mm3]变量 有无冠
脉硬化n M ± Q Z P PAT 有 133 185.97 ± 99.63 0.251 < 0.001* 无 90 137.71 ± 112.42 EAT 有 133 114.03 ± 58.78 0.327 < 0.001* 无 90 77.94 ± 57.25 EAT/PAT 有 133 0.6 ± 0.09 0.295 < 0.001* 无 90 0.56 ± 0.08 *P < 0.05。
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表 6 心脏周围脂肪体积（EAT、PAT、EAT/PAT）与CAS程度的相关性
Table 6. Correlation between the volume of pericardial adipose tissue （EAT，PAT，EAT/ PAT） and degree of CAS
分组 PAT EAT EAT/PAT r P r P r P 病变支数 0.357 < 0.001* 0.433 < 0.001* 0.409 < 0.001* Gensini积分 0.091 0.173 0.150 0.026* 0.221 0.001* CACS 0.151 0.024* 0.192 0.004* 0.196 0.003* CACS分级 0.078 0.416 0.160 0.081 0.225 0.004* *P < 0.05。
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