基于心脏磁共振的EAT体积与高血压心脏病左心室功能相关性研究

胡 延峰1, 苏 宁2
1、内蒙古科技大学包头医学院
2、包头市中心医院

摘要


背景：高血压作为我国最常见的慢性病之一。本研究旨在探讨EAT体积与HHD患者左心功能的相关性，明确EAT体积对HHD左心功能受损的预测价值，为HHD的早期诊断、病情评估提供可靠的影像学标志物，同时为深入理解HHD的病理生理机制提供实验依据。方法：选取HHD的患者64例，单纯高血压组63例，进行CMR动态电影成像扫描，采集心脏各腔室及短轴层面图像，用于左心房及左心室功能及应变的测量。通过短轴电影序列手动勾画心外膜脏层和脂肪壁壁层，自动生成EATV。结果：两组性别、年龄、LVEDVI、LVESVI、及SVI无统计学差异（P＞0.05）；HHD组BMI、EATV、LVMI、LVMWT更高，LVEF、CI及多数心室应变指标更低（均P＜0.05）。HHD组EATV与SRe、LVMI、LVMWT、GLS正相关（均P＜0.05）。多因素回归显示EATV是上述指标独立影响因素。ROC分析示EATV预测左心功能受损AUC0.758（95% CI：0.638～0.878），截断值174.155 ml，敏感度0.655，特异度0.800。结论：HHD患者存在明显的心外膜脂肪组织堆积，EATV与HHD患者左心室功能参数密切相关，是左心功能异常及左心室肥厚的独立影响因素，对HHD左心功能受损具有一定的临床预测价值，CMR可作为定量评估EATV及左心功能的可靠手段。

关键词


心外膜脂肪组织；心脏磁共振；高血压心脏病；心肌应变

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参考


[1]国家心血管病中心.中国心血管健康与疾病报告2024[M].北京：中国协和医科大学出版社，2025：55-71，108-116.

[2]Ji D, Zhang B, He B. The Diagnostic Value of the Deepest S Wave in 12-Lead Electrocardiogram to Elderly Patients with Essential Hypertension and Left Ventricular Hypertrophy. Clin Interv Aging. 2022;17:1663-1672. Published 2022 Nov 22.

[3]Gustafsson B, Rovio SP, Ruohonen S, et al. Determinants of echocardiographic epicardial adipose tissue in a general middle-aged population - The Cardiovascular Risk in Young Finns Study. Sci Rep. 2024;14(1):11982. Published 2024 May 25.

[4]Fang W, Xie S, Deng W. Epicardial Adipose Tissue: a Potential Therapeutic Target for Cardiovascular Diseases. J Cardiovasc Transl Res. 2024;17(2):322-333.

[5]Gorica E, Geiger MA, Di Venanzio L, et al. Cardiometabolic heart failure with preserved ejection fraction: from molecular signatures to personalized treatment. Cardiovasc Diabetol. 2025;24(1):265. Published 2025 Jul 3.

[6]D'Oria R, Genchi VA, Caccioppoli C, et al. Impact of Dysfunctional Adipose Tissue Depots on the Cardiovascular System. Int J Mol Sci. 2022;23(22):14296. Published 2022 Nov 18. Iacobellis G. Epicardial adipose tissue in contemporary cardiology. Nat Rev Cardiol. 2022;19(9):593-606.

[7]1.Iacobellis G. Epicardial adipose tissue in contemporary cardiology. Nat Rev Cardiol. 2022;19(9):593-606.

[8]Madonna R, Massaro M, Scoditti E, Pescetelli I, De Caterina R. The epicardial adipose tissue and the coronary arteries: dangerous liaisons. Cardiovasc Res. 2019;115(6):1013-1025.

[9]石惠，张瑞荣，马思，等.基于磁共振组织追踪技术评价高血压心脏病左、右心室心肌应变[J].中国医学影像学杂志，2025，33（09）：993-998.

[10]Austys D, Dobrovolskij A, Jablonskienė V, Dobrovolskij V, Valevičienė N, Stukas R. Epicardial Adipose Tissue Accumulation and Essential Hypertension in Non-Obese Adults. Medicina (Kaunas). 2019;55(8):456. Published 2019 Aug 9.

[11]Ran CQ, He WT. Epicardial Adipose Tissue: A Potential Target to Improve Left Ventricular Diastolic Dysfunction. Rev Cardiovasc Med. 2025;26(9):39224. Published 2025 Sep 25.

[12]Wu HX, Liu M, Mao W, et al. Epicardial adipose tissue volume outperforms density in association with cardiorenal complications in hypertensive patients. Lipids Health Dis. Published online February 12, 2026.

[13]Ma W, Zhang B, Yang Y, et al. Association of epicardial fat thickness with left ventricular diastolic function parameters in a community population. BMC Cardiovasc Disord. 2021;21(1):262. Published 2021 May 28.

[14]Tang Y, Pan Z, Wen J, et al. Epicardial adipose tissue associated with right cardiac chamber remodelling in patients with connective tissue disease evaluated by cardiac magnetic resonance: a cross-sectional study. Clin Radiol. 2025;87:106958.

[15]Upadhaya S, Pandey AC, Wiley J, Le Jemtel TH. Clinical correlates of perivascular adipose tissue in coronary artery disease and obesity. Front Physiol. 2025;16:1651249. Published 2025 Aug 26.

[16]1.Zhu J, Li W, Xie Z, Zhuo K. Relationship Between Epicardial Adipose Tissue and Biventricular Longitudinal Strain and Strain Rate in Patients with Type 2 Diabetes Mellitus. Acad Radiol. 2023;30(5):833-840.


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