Yaş dağılımına göre epikardiyal yağ doku radyodansitesinin değerlendirilmesi

Öz

Amaç: Yağ doku dejenerasyonu değerlendirmenin sınıflanması kardiyak tomografi (KT) kullanarak biyolojik karakteristiklerin ayırmak için önemli bir biyoradyolojik göstergedir. Epikardiyal yağ doku dejenerasyonu kalp hastalıklarına neden olmakla suçlanmaktadır. Fakat yaş ile epikardiyal yağ doku dejenerasyonu arasında ilişki çok iyi bilinmemektedir. Bu çalışmada biz KT kullanarak epikardiyal yağ doku radyodansitesi inceledik. Yöntemler: 2018 Haziran ve Temmuz 2019 yılları arasında 147 hastanın orta derece olasılık koroner arter hastalığı için orta derece olasılık nedeniyle koroner arterleri KT ile değerlendirilmesi yapıldıç Bu restrospektif kohort çalışmadır. Üç epikardiyal bölge (sağ atriyoventriküler groove, posterior interventriküler groove ve anterior epikardiyal) radyodansitesi ve bireysel subxiphoid yağ radyodansitesi elde edildi. Grup karşılaştırılmaları 10 yıllık periyodlara göre yapıldı (10 ile 80 yaş arası). Bulgular: Epikardiyal yağ doku / subxiphoid yağ radyodansitesi oranları artan yaş ile azalmaktadır. Üçüncü 10 yıl sonrası epikardiyal yağ doku / subxiphoid yağ radyodansitesi oranları keskin bir şekilde azaldığını gözlemledik. Pearson correlation oranı negative ve r=-0,11). Yirmi ve 30 yaş arası ile 30-40 yaş arası LCX bölgesi sırasıyla 1,71 (0,14) vs. 1,06 (0,40); P<0,001). RCA bölgesinde ayni yaşlarda sırasıyla 1,71 (0,20) vs. 1,04 (0,30) P<0,001.Anterior epikardiyal bölge aynı yaşlarda sırasıyla 1,70 (0,07) vs. 1,17 (0,42) P<0,001. Sonuç: Epikardiyal yağ doku radyodansitesi oranı değişikliği yaş ile bağlantılıdır. Artan yaş daha az epikardiyal yağ doku radyodansitesi oranı ile ilişkilidir. Bu ilişki yağ dejenerasyonu kabul edilir (negatif korelasyon). Biz bu değişikliklerin 3. 10 yıl sonrası keskin bir şekilde olduğunu gözlemledik.

Anahtar Kelimeler

• Epikardiyal yağ dokusu
• Radyodansite oranı
• Yağ dejenerasyonu

The evaluation of epicardial adipose tissue radiodensity according to age

Öz

Aim: The grading of fatty degeneration by cardiac computerized tomography (CCT) is an important bioradiological marker to discriminate biological characteristics. Epicardial adipose tissue (EAT) degeneration has been accused of causing heart disease. However, the relationship between age and EAT radiodensity is not well known. In this study we examined epicardial adipose tissue radiodensity with CCT. Methods: A total of 147 subjects who underwent contrast-enhanced evaluation of coronary arteries with CCT between Jun 2018-July 2019 due to intermediate probability of coronary artery disease (CAD) were included in this retrospective cohort study. The radiodensities of three epicardial regions (right atrioventricular groove, posterior interventricular groove, and anterior epicardial area) and individual subxiphoid fat radiodensity ratios were obtained. Group comparisons were made according to 10-year-periods (between 10- 80 years of age). Results: We found that epicardial adipose tissue/ subxiphoid fat radiodensity ratio decreased with increasing age. After the 3rd decade, we detected a negative correlation between EAT/subxiphoid fat radiodensity ratio (r=-0.11). The radiodensity ratios of patients between 20-30 and 30-40 years of age in the LCX, RCA and anterior epicardial regions were 1.71 (0.14) and 1.06 (0.40) (P<0.001), 1.71 (0.20) and 1.04 (0.30) (P<0.001), and 1.70 (0.07) and 1.17 (0.42), respectively (P<0.001). Conclusion: EAT radiodensity ratio changes are associated with aging. Increased age is negatively correlated with EAT radiodensity ratio, which is considered fat degeneration. We realized that those changes occurred sharply after the third decade.

Anahtar Kelimeler

• Epicardial adipose tissue
• Fatty degeneration
• Radiodensity ratio

Kaynakça

1. 1. Pracon R, Kruk M, Kepka C, Pregowski J, Opolski MP, Dzielinska Z, et al. Epicardial adipose tissue radiodensity is independently related to coronary atherosclerosis. A multidetector computed tomography study. Circ J. 2011;75(2):391-7.
2. 2. Franssens BT, Nathoe HM, Visseren FL, van der Graaf Y, Leiner T; SMART Study Group. Relation of Epicardial Adipose Tissue Radiodensity to Coronary Artery Calcium on Cardiac Computed Tomography in Patients at High Risk for Cardiovascular Disease. Am J Cardiol. 2017;119(9):1359-65.
3. 3. Chekakie MO, Welles CC, Metoyer R, Ibrahim A, Shapira AR, Cytron J, et al. Pericardial fat is independently associated with human atrial fibrillation. J Am Coll Cardiol. 2010;56:784-8.
4. 4. Wang CP, Hsu HL, Hung WC, Yu TH, Chen YH, Chiu CA, et al. Increased epicardial adipose tissue (EAT) volume in type 2 diabetes mellitus and association with metabolic syndrome and severity of coronary atherosclerosis. Clin Endocrinol (Oxf). 2009;70:876-82.
5. 5. Eroglu S, Sade LE, Yıldırır A, Demir O, Muderrisoglu H. Association of epicardial adipose tissue thickness by echocardiography and hypertension. Turk Kardiyol Dern Ars. 2013;41(2):115-22.
6. 6. Hamrahian AH, Ioachimescu AG, Remer EM, Motta-Ramirez G, Bogabathina H, Levin HS, et al. Clinical utility of noncontrast computed tomography attenuation value (Hounsfield units) to differentiate adrenal adenomas/hyperplasias from nonadenomas: Cleveland Clinic experience. J Clin Endocrinol Metab. 2005;90:871-7.
7. 7. Korobkin M, Brodeur FJ, Yutzy GG, Francis IR, Quint LE, Dunnick NR, et al. Differentiation of adrenal adenomas from nonadenomas using CT attenuation values. Am J Roentgenol. 1996;166:531-6.
8. 8. Motoyama S, Sarai M, Harigaya H, Anno H, Inoue K, Hara T, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49-57.

9. 9. Pundziute G, Schuijf JD, Jukema JW, Decramer I, Sarno G, Vanhoenacker PK, et al. Head-to-head comparison of coronary plaque evaluation between multislice computed tomography and intravascular ultrasound radiofrequency data analysis. JACC Cardiovasc Interv. 2008;1:176-82.
10. 10. Mahnken AH, Bruners P, Bornikoel CM, Kramer N, Guenther RW. Assessment of myocardial edema by computed tomography inmyocardial infarction. JACC Cardiovasc Imaging. 2009;2:1167-74.
11. 11. Pracon R, Kruk M, Kepka C, Pregowski J, Opolski MP, Dzielinska Z, et al. Epicardial adipose tissue radiodensity is independently related to coronary atherosclerosis. A multidetector computed tomography study. Circ J. 2011;75(2):391-7.
12. 12. Rabkin SW. Epicardial fat: properties, function and relationship to obesity. Obes Rev. 2007;8:253-61.
13. 13. Corradi D, Maestri R, Callegari S et al. The ventricular epicardial fat is related to the myocardial mass in normal, ischemic and hypertrophic hearts. Cardiovasc Pathol. 2004;13:313-6.
14. 14. Lip GY, Nieuwlaat R, Pisters R, Lane DA,Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolismin atrial fibrillation using a novel risk factor-based approach: the Euro HeartSurvey on Atrial Fibrillation. Chest. 2010;137:263-72.
15. 15. Hazzard WR, Ettinger WH Jr. Aging and atherosclerosis: changing considerations in cardiovascular disease prevention as the barrier to immortality is approached in old age. Am J Geriatr Cardiol. 1995;4:16-36.