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Effect Of Epicardial Adipose Tissue Thickness On Left Atrial Function In Patients With Ejection Fraction Preserved Heart Failure

Posted on:2024-06-24Degree:MasterType:Thesis
Country:ChinaCandidate:D GaoFull Text:PDF
GTID:2544306932971019Subject:Medical imaging and nuclear medicine
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Research backgroud:Epicardial adipose tissue(EAT)is a special form of visceral fat around the heart,many studies have shown that EAT is related to cardiac and metabolic diseases,EAT is associated with risk factors of heart failure with preserved ejection fraction(HFp EF),such as obesity,hypertension,diabetes and metabolic syndrome.Few studies have directly explored the relationship between EAT and HFp EF,compared to heart failure with reduced ejection fraction(HFr EF)and heart failure with mid-range ejection fraction(HFmr EF).The purpose of this study was to investigate the relationship of the thickness of epicardial adipose tissue and left atrial function in patients with HFp EF.It is expected to provide more comprehensive reference indicators for the treatment of HFp EF.Objectives:The purpose of this study was to evaluate the EAT and the left atrial function in patients with HFp EF,and explore the correlation between EAT and left atrial function.Methods:Forty-two patients with HFp EF who were examined from January 2021 to December 2022 in the Second Affiliated Hospital Of Dalian Medical Univresity,were collected as HFp EF group,and forty-two healthy volunteers who admitted with age and sex were selected as control group.The patient’s clinical features and biochemical parameters of the patients were recorded,including sex,age,height,body mass index,body surface area,brain natriuretic peptide(BNP),blood glucose.EAT and Left atrial diameter(LAD)was measured by transthoracic echocardiography.Pulsed Doppler imaging evaluation of mitral inflow shows the peak E velocity.Mitral annulus movement assessed on tissue Doppler imaging shows diastolic velocity(e’),and the average E/e’ was calculated.Besides,4-Dimensinal automated left atrial quantification technique was applied to measured and evaluate the maximum left atrial end-systolic volume(LAVmax),minimum left atrial diastolic volume(LAVmin),left atrial volume before the P wave on electrocardiogram(LAVpre A),left atrial ejection fraction(LAEF),maximum volume index(LAVImax),Left atrial reservoir strain(LASr),Left atrial conduit strain(LAScd),Left atrial contractile strain(LASct).The clinical features,EAT and the left atrial function were compared between the two groups.Pearson correlation method was used to study the correlation between EAT and the absolute values of LASr,LASct,LAScd,LAEF and BMI.Multivariate logistic regression was used to analyze the independent risk factors of HFp EF.Results:The EAT thickness of HFp EF patients was significantly higher than that of control group(9.81±1.61 & 6.52±1.73,P < 0.05);LAD,LAVpre A and E/e’ were higher than those in the healthy control group(40.76±3.73 & 34.95±2.58,76.40±20.40& 38.00±13.20,14.42±5.02 & 9.21±2.29,all P < 0.05);The left atrial strain parameters(LASr,LASct,LAScd)of HFp EF patients were significantly lower than those of the control group(17.88±6.23 & 29.71±5.91,-8.70±2.70 &-15.00±3.69 和-9.45±4.76 &-16.33±6.01,all P<0.05);LAVmax,LAVmin and LAVImax in HFp EF group were higher than those in the control group(95.21±20.98 &57.33±7.57,60.79±13.85 & 23.12±6.28,49.62±12.72 & 31.02±2.75,all P<0.05),but LAEF was lower than that in the control group(39.26±7.78 & 45.52±6.58,P<0.05).In pearson correlation analysis,the absolute values of EAT,LASr,LASct,LAScd and LAEF have significant negative correlation(P < 0.001).Logistic analysis showed that EAT,LASr and LAScd were independent risk factors for HFp EF.Conclusion:(1)In HFp EF patients,the thickness of EAT increased,the left atrial volume increased and strain decreased;(2)The thickness of EAT has certain correlation with left atrial strain parameters;(3)The thickness of EAT combined with the left atrial strain can better predict the risk of HFpEF.
Keywords/Search Tags:Epicardial adipose tissue, Heart failure with preserved ejection fraction, Left atrial reservoir strain, Left atrial conduit strain, Left atrial contractile strain
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