Nurullah YÜCEL, Tayfun AYGUN, Meryem Esma DÜZ, Gulam HEKİMOĞLU, Mustafa Ahmet HUYUT, Mehmet KIZILAY, Muzaffer ŞEKER

"Epikard Yağ Dokusu Artışı ile Aort Genişlemesi Arasındaki İlişki: Hipertansiyon Komplikasyonlarının Göstergesi Olabilir"

Öz Arka plan/Amaç: Epikardiyal yağ dokusu (EFT), miyokardın yüzeyinde ve visseral perikardın altındaki yağ dokusunu ifade eder. Endokrin sisteme ve miyokardın enerji metabolizmasına katılır. Bu çalışma, aort dilatasyonu ile ilişkili hipertansiyon (HT) komplikasyonları için EFT'nin non invaziv bir belirteç olma potansiyelini araştırmayı amaçlamıştır. Yöntem: Çalışmanın sağlıklı kontrol (HC) grubunu tansiyonu normal olan 70 hasta, HT grubunu ise tansiyonu yüksek olan 82 hasta oluşturdu. HT grupları prehipertansif, evre 1, evre 2 ve evre 3 olmak üzere dört kategoriye ayrıldı. EFT parasternal uzun eksenden iki boyutlu ekokardiyografi ile değerlendirilerek HC ve HT grupları arasında karşılaştırıldı. Bulgular: HT grubunda EFT kalınlığı HC'ye göre oldukça yüksekti (5,7±1,9 vs 4,0±1,3, p<0,05). Çok değişkenli regresyon analizinde ofis kan basıncı (p<0,05, %95 GA 0,827-0,935), ejeksiyon fraksiyonu (p<0,05, %95 GA 1,033-1,495) ve EFT (p<0,05, %95 GA 0,413-0,807) HT ve HC gruplarının ayrılmasında bağımsız değişkenler olduğu bulunmuştur. EFT kalınlığının duyarlılığı 73,2, özgüllüğü ise 4,15 kesme değerinde %57,1 idi. EFT sırasıyla sinüs valsalva (r2=0.08, p<0.05), sinotubüler bileşke (r2=0.06, p<0.05) ve aort çıkış çapı (r2=0.07, p<0.05) ile anlamlı düzeyde koreleydi. HT alt grupları arasında EFT'de herhangi bir farklılık tespit edilmedi. Sonuç: EFT, HT ile ilişkili komplikasyon riskinin arttığını ortaya koyan bir belirteç olabilir.

Anahtar Kelimeler:

hipertansiyon, morfometri, biyobelirteç, epikardiyal yağ dokusu, komplikasyonlar

"Relationship between Increased Epicardial Fat Tissue and Aortic Dilatation: may be an Indicator of Hypertension Complications"

Abstract Background/Aims: Epicardial fat tissue (EFT) refers to the adipose tissue on the myocardium's surface and beneath the visceral pericardium. It participates in the endocrine system as well as the myocardium's energy metabolism. This study aimed to investigate the potential of EFT as a noninvasive marker for hypertension (HT) complications associated with aortic dilatation. Methods: The study's healthy control (HC) group consisted of 70 patients with normal blood pressure and the HT group consisted of 82 patients with higher blood pressure. HT groups were separated into four categories, prehypertensive, stage 1, stage 2, and stage 3. EFT was assessed by two-dimensional echocardiography from the parasternal long axis and compared between the HC and the HT groups. Results: The EFT thickness in the HT group was considerably higher than in the HC (5.7±1.9 vs 4.0±1.3, p<0.05). In multivariate regression analysis, office blood pressure (p<0.05, 95% CI 0.827-0.935), ejection fraction (p<0.05, 95% CI 1.033-1.495), and EFT (p<0.05, 95% CI 0.413-0.807) were found to be independent variables in the separation of HT and HC groups. EFT thickness had a sensitivity of 73.2 and a specificity of 57.1% at a cut-off value of 4.15. EFT was significantly correlated with sinus valsalva (r2=0.08, p<0.05), sinotubular junction (r2=0.06, p<0.05), and aorta ascendence diameter (r2=0.07, p<0.05), respectively. EFT among HT subgroups, no differences were identified. Conclusion: EFT can be a marker revealing an increased risk of HT-related complications.

Keywords:

hypertension, biomarker, epicardial fat tissue, complications, morphometry,

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