| Background and Objective Epicardial adipose tissue(EAT) was a kind of visceraladipose tissue, it mainly concentrated in the atrioventricular groove and the largebranch of coronary artery, partly along the atrial, right ventricular free wall and leftventricular apex distribution.Currently, it was considered also an endocrine organsecreting a lot of inflammatory cytokines. Due to unique anatomical location,inflammatory factors secreted by EAT could be involved in cardiac remodeling andaffected cardiac function, in the study the relationship between EAT and leftventricular diastolic dysfunction (LVDD) in patients with hypertension was explored.Methods Atotal of175consecutive hypertensive patients were included in SecondHospital of Nanchang University. The baseline characteristics of participantsincluding age, sex, weight and waist circumference were noted. Serum levels ofhigh-sensitivity C-reactive protein (Hs-CRP) and fasting blood glucose were alsorecorded. EAT, identified as an echo-free space between the visceral pericardial layerand myocardium on2-dimensional echocardiography, was measured perpendicularlyin front of the right ventricular free wall at end-diastole. The early diastolic mitralannular velocity e’from septal and lateral sites of the mitral leaflets, peak velocitiesof the early phase (E) and late phase (A) of the transmitral inflow, Interventricularseptum (IVS), posterior wall (PW), left ventricular end-diastolic diameter (LVEDD),and left atrium dimension were measured. Then left ventricular diastolic function wasassessed according to ESC guidelines for diagnosis of chronic heart failure in2012and the American Society of Echocardiography guidelines(E/e’>15；8<E/e’<15，e’, E/A, e’/a’). At last, patients were classified into two groups, hypertensive patientswith normal left ventricular diastolic function (n=72) and hypertensive patients withLVDD (n=103).The comparisons about EAT thickness, Hs-CRP and left atriumdimension were performed between two groups. Therefore, pearson correlationcoefficient was used to analyze the relationship between EAT thickness, Hs-CRP andleft atrium dimension. Regression analysis and ROC curve analysis were conducted. Results Compared with hypertensive patients group with normal left ventriculardiastolic function, EAT thickness [(5.18±1.64)mm vs.(3.95±1.20)mm, P<0.01],Hs-CRP [(2.06±2.33)mg/l vs.(1.14±1.60)mg/l, P=0.03], left atrium dimension[(33.12±4.09)mm vs.(31.13±3.06)mm, P<0.01], LVM[(167.11±42.78)g vs.(146.77±30.36)g, P<0.01], LVMI[(100±26.09)g/m2vs.(88.61±16.04)g/m2,P<0.01]were more increased in patients group with LVDD. Liner correlation analysisindicated that EAT thickness was related to left atrium dimension(r=0.29, P<0.01)and Hs-CRP(r=0.20, P<0.01), LVM significantly correlated with Hs-CRP(r=0.25,P<0.01),waist circumference(r=0.38, P<0.01), left atrium dimension was also relatedto Hs-CRP (r=0.22, P<0.01). Multiple linear regression analysis revealed that waistcircumference was independently correlated with Hs-CRP (t=4.99, P<0.01) and LVM(t=5.09, P<0.01). EAT thickness (t=2.35, P=0.02), waist circumference and LVDDwere independently associated with left atrium dimension. Logistic regressionanalysis revealed that EAT thickness (OR=1.57, P<0.01), age (OR=1.10, P<0.01) andwaist circumference (OR=1.05, P=0.01) were associated with LVDD in patients withhypertension. ROC curve analysis indicated that with EAT≥4.15mm as the cutoffvalue for diagnosing LVDD, sensitivity and specificity were70.9％and65.3％, thearea under the ROC curve was72.0%(P<0.01).Conclusion Compared with hypertensive patients group with normal leftventricular diastolic function, EAT thickness was more increased in patients groupwith LVDD. EAT, considered a special anatomical organ, might participate in atrialand ventricular remodeling, and then it could affect LVDD. Meanwhile, EAT could beused as a noninvasive collaborative diagnostic method for hypertensive patients withLVDD. EAT might be involved in influencing Hs-CRP. |
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