Elif UZUN ATA, Nilgün IŞIKSALAN ÖZBÜLBÜL

Epikardiyal yağ dokusu ve hepatosteatoz ile koroner ateroskleroz arasındaki ilişkinin çok kesitli bilgisayarlı tomografi ile değerlendirilmesi

Giriş: Bu çalışmada çok kesitli bilgisayarlı tomografi (ÇKBT) kullanılarak, epikardiyal yağ doku volümü ve hepatosteatozun koroner arter hastalığı ile ilişkisi araştırıldı. Gereç ve Yöntem: Koroner arter hastalığı (KAH) ön tanısıyla koroner bilgisayarlı tomografi (BT) anjiyografi tetkiki yapılan 96 hastada epikardiyal yağ volümü, koroner kalsiyum skoru ve karaciğer BT dansitesi ölçüldü. Epikardiyal yağ volümü, koroner kalsiyum skoru ve karaciğer dansitesi arasındaki ilişki ile koroner kalp hastalığını saptamadaki performansları araştırıldı. Verilerin analizi MedCalc (Version 9.6.2.0) paket programı ile yapıldı. Bulgular: Koroner kalsiyum skoru (EAA=0,866) ve epikardiyal yağ volümü (EAA=0,672) koroner aterosklerozu belirlemede istatiksel olarak etkin bulundu. Koroner arter hastalığını saptamada koroner kalsiyum skoru ölçümünün tanısal etkinliği, epikardiyal yağ volümü ölçümünün tanısal etkinliğinden yüksek bulundu. KAH olanlarda epikardiyal yağ volümü (85,81±34,51 cm³), KAH olmayanlara göre (68,38±29,23 cm³) daha yüksek bulundu (P=0,0119). KAH olanlarda karaciğer BT dansitesi (58,74±12,22 HU), KAH olmayanlara göre (63,02±8,93) istatistiksel olarak sınırda düşük bulundu (P=0,0553). Epikardiyal yağ volümü ile kalsiyum skoru arasında (r=0,1620, P=0,1148), epikardiyal yağ volümü ile karaciğer BT dansitesi arasında (r=0,0046, P=0,9648) ve kalsiyum skoru ile karaciğer BT dansitesi arasında (r=0,0109, P=0,9162) istatistiksel olarak anlamlı ilişki saptanmadı. Sonuç: Epikardiyal yağ volümü, hepatosteatoz ve koroner kalsiyum skoru arasında bir ilişki yoktur. Epikardiyal yağ volümü KAH olanlarda, KAH olmayanlara göre daha yüksektir. Epikardiyal yağ volümü ölçümü, KAH’ı göstermede orta derecede tanısal etkinliğe sahiptir ancak gücü koroner kalsiyum skorlamasına göre daha azdır.

Anahtar Kelimeler:

Koroner Ateroskleroz, Epikardiyal Yağ Doku, Hepatosteatoz, ÇKBT

Evaluation of the relation between epicardial adipose tissue and hepatosteatosis with coronary atherosclerosis using multidetector computed tomography

Background: In this study, the relationship of CAD (coronary artery disease) with EAT (epicardial adipose tissue) volume and hepatosteatosis were investigated by using multidetector computed tomography (MDCT). Material and Method: EAT (Epicardial Adipose Tissue) volume, CCS (coronary calcium score) and CT density of liver (CTDL) were measured by using 64-detector computed tomography in 96 patients who were clinically referred for the evaluation of CAD. The relationship between EAT volume, CCS, CTDL and their effectiveness in detecting coronary heart disease were investigated. Data analysis was done with MedCalc (Version 9.6.2.0) package program. Results: CCS (AUC=0.866) and EAT volume (AUC=0.672) were significantly effective in determination of CAD. The diagnostic accuracy of CCS in detecting CAD was higher than of EAT volume. EAT volume was higher in patients with CAD (85.81±34.51 cm³), compared to patients without CAD (68.38±29.23 cm³) (P=0.0119). CTDL in patients with CAD (58.74±12.22 HU) was significantly lower than in patients without CAD (63.02±8.93) (P=0.0553). There was no statistically significant relationship between EAT volume and CCS (r=0.1620, P=0.1148), EAT volume and CTDL (r=0.0046, P=0.9648), and CCS and CTDL (r=0.0109, P=0.9162). Conclusion: There was no relationship between EAT volume, CTDL and CCS. EAT volume is higher in patients with CAD than in patients without CAD. EAT volume had moderate but lower diagnostic power than CCS, to determine CAD.

Keywords:

Coronary atherosclerosis, Epicardial adipose tissue, Hepatosteatosis, MDCT,

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