Известно, что эпикардиальный жир (ЭЖ) является гормонально-активным и оказывает непосредственное влияние на состояние миокарда и коронарного русла. Цель данного исследования – сравнительный анализ взаимосвязи толщины эпикардиального жира (ТЭЖ) и окружности талии с основными и дополнительными метаболическими факторами риска и степенью атеросклеротического поражения коронарного русла у пациентов с ишемической болезнью сердца. Материалы и методы. Обследованы 138 мужчин 55,86±6,43 года со стенокардией напряжения II–III функционального класса. Проводилась оценка аполипопротеинов (Апо-А1, Апо-В), уровней лептина, резистина плазмы. С помощью эхокардиографии оценивалась ТЭЖ. Всем пациентам проводилась коронароангиография. Результаты. Выявлены взаимосвязь ТЭЖ с основными метаболическими факторами риска, а также ее корреляция с уровнями Апо-А1, Апо-В, лептина, резистина плазмы. Показано, что ТЭЖ взаимосвязана со степенью поражения коронарного русла у пациентов с ишемической болезнью сердца.
It is known that epicardial fat (EF) is gormonalno active, making direct impact on a myocardium and a coronary arteries. Aim. To carry out the comparative analysis of interrelation of a thickness epicardial fat (tEF) and waist circumference with the basic and additional metabolic risk factors (RF) and degree of atherosclerotic defeat of coronary arteries at patients with an coronary artery disease (CAD). Materials and methods. The study included 138 men, 55,86±6,43 years, with angina II–III functional class. The estimation apolipoproteins (ApoA1, ApoB), level leptin, resistin was spent. By means of echocardiography it was estimated tEF. To all patients it was spent diagnostic coronary angiography. Results. The interrelation tEF with the cores metabolic RF, and also correlation tEF with Apo-А1, Apo-B, leptin, resistin plasmas is revealed. Besides, the increase tEF has been connected with more crushing defeat of a coronary arteries at patients with CAD.
1. Kannel WB. Sixty years of preventive cardiology: a framingham perspective. Clin Cardiol 2011; 34 (6): 342–3.
2. Juge-Aubry CE, Henrichot E, Meier CA. Adipose tissue: a regulator of inflammation. Best Pract Res Clin Endocrinol Metab 2005; 19 (4): 547–66.
3. Brook RD. Obesity, weight loss, and vascular function. Endocrine 2006; 29 (1): 21–5.
4. Montani JP, Carroll JF, Dwyer TM. Ectopic fat storage in heart, blood vessels and kidneys in the pathogenesis of cardiovascular diseases. Int J Obes Relat Metab Disord 2004; 28 (4): 58–65.
5. Moore KL, Persaud TN. The developing human. Clinically oriented embryology. 7th ed. Philadelphia, PA: Saunders 2003; 189.
6. Malavazos AE, Ermetici F, Cereda E et al. Epicardial fat thickness: relationship with plasma visfatin and plasminogen activator inhibitor-1 levels in visceral obesity. Nutr Metab Cardiovasc Dis 2008; 18 (8): 523–30.
7. Iacobellis G, Willens HJ. Echocardiographic Epicardial Fat: A Review of Research and Clinical Applications. JASE 2009; 22 (12): 1311–9.
8. Чумакова Г.А., Веселовская Н.Г., Козаренко А.А. Эпикардиальное жировое депо: морфология, диагностика, клиническое значение. Сердце. 2011; Т. 10, 3 (59): 143–7.
9. Iacobellis G, Assael F, Ribaudo MC et al. Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction. Obes Res 2003; 11 (2): 304–10.
10. Aydin H, Toprak A, Deyneli O et al. Epicardial Fat Tissue Thickness Correlates With Endothelial Dysfunction and Other Cardiovascular Risk Factors in Patients With Metabolic Syndrome. Metab Syndr Relat Disord 2010; 8 (3): 229–34.
11. Iacobellis G, Pistilli D, Gucciardo M et al. Adiponectin expression in human epicardial adipose tissue in vivo is lower in patients with coronary artery disease. Cytokine 2005; 29 (6): 251–5.
12. Silaghi A, Achard V, Paulmyer-Lacroix O et al. Expression of adrenomedullin in human epicardial adipose tissue: role of coronary status. Am J Physiol Endocrinol Metab 2007; 293 (5): 1443–50.
13. Nelson MR, Mookadam F, Thota V. Epicardial Fat: An Additional Measurement for Subclinical Atherosclerosis and Cardiovascular Risk Stratification. J Am Soc Echocardiogr 2011; 24 (3): 339–45.
14. Pracon R, Kruk M, Kepka C. Epicardial Adipose Tissue Radiodensity Is Independently Related to Coronary Atherosclerosis. Circ J 2011; 75 (2): 391–7.
1 Research Institute for Complex Problems of Cardiovascular Diseases, Siberian Branch of the Russian Academy of Medical Sciences, Kemerovo;
2 Altai Territorial Cardiology Dispensary, Barnaul;
3 Altai State Medical University, Barnaul
*g.a.chumakova@mail.ru