JACC:心包脂肪量越多,心衰风险越高!

2021-06-02 Nebula MedSci原创

心包脂肪量升高主要增加了射血分数保留的HF风险~

肥胖是公认的心力衰竭(HF)的危险因素。然而,心包脂肪对心衰的影响尚不清楚

最新发表在“J Am Coll Cardiol”上的研究“Pericardial Fat and the Risk of Heart Failure”,旨在探讨心包脂肪量(PFV)与新确诊的心衰之间的关系。

在该研究中,研究人员对MESA试验的6785名既往无血管疾病的受试者(3584名女性和3201名男性)进行了心脏计算机断层扫描,以明确心包脂肪量,并采用Cox比例风险回归法评估PFV与心衰的相关性。

中位随访了15.7年,共90686人·年,385名受试者(5.7%;164名女性和221名男性)新确诊为心衰。女性心包脂肪量少于男性(69±33 cm3 vs. 92±47 cm3;p<0.001)。

不同心包脂肪量人群的累积心衰率

在多变量分析中,心包脂肪量每增加1-SD (42 cm3)与女性HF的高风险相关(危险比[HR]: 1.44;95%CI: 1.21-1.71;p<0.001),且高于男性(HR: 1.13;1.01-1.27;p=0.03)(交互作用p=0.01)。高心包脂肪量(女性≥70 cm3;男性≥120 cm3)使女性的HF风险增加了2倍(HR:2.06;95%CI:1.48-2.87;p<0.001),使男性的HF风险增加了53% (HR: 1.53;95%CI:1.13-2.07;p=0.006)。

在性别分层分析中,对以下指标进行额外调整后,高心包脂肪量个体的较高HF风险依然具有显著性:个体肥胖指标(p≤0.008)、腹部皮下和内脏脂肪(p≤0.03)或炎症生物标志物和血流动力学压力(p<0.001);而且,心包脂肪量与高HF风险的相关性在白人、黑人、西班牙裔和中国人中相近(p=0.24)。

心包脂肪量对射血分数不同的HF风险的影响

心包脂肪量升高主要增加了射血分数保留的HF风险(p<0.001),但对射血分数降低的HF风险无显著影响(p=0.31)。

综上,心包脂肪量与心衰风险增加相关,尤其是与射血分数保留的心衰。

原始出处:

Kenchaiah Satish,Ding Jingzhong,Carr J Jeffrey et al. Pericardial Fat and the Risk of Heart Failure. J Am Coll Cardiol, 2021, 77: 2638-2652.

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    2021-07-25 清幽蓝燕yan

    学习了

    0

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    2021-08-16 hbwxf
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    2021-07-10 十八线开外美少女

    心包脂肪只要对HFp EF起作用

    0

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    2021-06-03 ANNIETIGER

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