The Study On The Relationship Between Epicardial Adipose Tissue And Left Ventricular Diastolic Function In Patients With Coronary Heart Disease

ObjectiveThis study was designed to analyze the effect of epicardial adipose tissue volume(EATV)on left ventricular diastolic function(LVDF)in patients with coronary heart disease(CHD)undergoing percutaneous coronary intervention(PCI).To investigate the long-term predictive value of EATV for LVDF in patients with CHD after PCI,and to provide new therapeutic targets and scientific basis for the improvement of LVDF after PCI in CHD patients.MethodsIn this study a cross-sectional study was used to enroll 268 patients with CHD who were treated with PCI in TEDA International Cardiovascular Hospital because of unstable angina.Before PCI,EATV was measured by 64-slice spiral computed tomography(CT)and echocardiography was used to assess the structure and function of heart.In the early morning of the second day of admission,fasting venous blood was collected and fasting blood glucose,TNF-?,blood lipids,D-dimer,adiponectin,IL-6,GGT,Hs-CRP,and other indicators were measured by the same experienced clinician.And collected the echocardiographic data at the time of review 1 year later.EpiData 3.1 and SPSS 20.0 were used for data entry and statistical analysis.One-way analysis of variance,Pearson correlation analysis,ROC curve,single factor and multivariate logistic regression analysis were performed.The test level is ?=0.05.Results1.Grouping by age,gender and BMI,the results showed the HDL levels in>60 years old were higher than ?60 years old group(P<0.05);The TC,HDL and GGT of femal were higher,while uric acid and LV-Dd were higher in males(P<0.05);HDL and adiponectin levels in Obesity group were less than normal and overweight group,uric acid,TNF-?,Hs-CRP,EATV,IVS-Td,IL-6 levels and LA-Ds were higher in obesity group than in normal and overweight groups,and LVEF index in overweight group was higher than the normal group.The E/A value in normal group was higher than that in the overweight and obesity groups(P<0.05).2.Pearson correlation analysis showed a negative correlation between EATV and E/A(r=-0.516,P<0.05).Partial correlation analysis showed that there was a negative correlation after control of BMI(r=-0.503,P<0.05).Single factor logistic regression analysis of LVDD finds age,BMI,IL-6,HS-CRP,adiponectin,number of lesions,fasting glucose and EATV were statistically significant(P<0.05).Multivariate logistic regression analysis showed that BMI,adiponectin and EATV were statistically significant(P<0.05),EATV(OR=1.046,P<0.05)and overweight(OR=3.081,P<0.05)were risk factors for LVDD,adiponectin was protective factors(OR=0.839,P<0.05).Single factor logistic regression analysis of decreased LVDF after one year showed that EATV remained a risk factor for LVDF reduction(OR=1.016,P<0.05).3.The ROC curve showed AUC was 0.838,when EATV was 126.36 cm3(sensitivity was 57.1%,specificity was 92.3%).The ROC curve of LVDF diagnosis performed by EATV one year later showed AUC=0.712,when EATV 120.55cm3 the sensitivity was 60.7% and the specificity was 75.5%.Conclusion1.In CHD patients undergoing PCI,EATV is associated with BMI,and EATV is significantly increased in obese and overweight patients.2.In CHD patients undergoing PCI,EATV is associated with a reduction in LVDF and may serve as a risk factor.It has a certain predictive effect on the reduction of LVDF in patients with CHD and who reviewing one year later.In the future,we can consider the EATV's mechanism of LVDF as the starting point for research.3.The ROC curve indicates that EATV has certain diagnostic significance for LVDF reduction in CHD patients,which providing a new reference for the diagnosis.4.The inflammatory factors and adiponectin are associated with LVDD.IL-6 and Hs-CRP are risk factors forLVDD,while adiponectin is a protective factor.