Fethi YAVUZ, Mehmet KÜÇÜKOSMANOĞLU, Mustafa DOĞUŞ, Arafat YILDIRIM, Salih KILIÇ

Epikardiyal Yağ Dokusu Kalınlığı ve Safen Ven Greft Hastalığının Patofizyolojisi ile İlişkisi

GİRİŞ ve AMAÇ: Teknik ve tıbbi ilerlemelere rağmen SVGH, yüksek morbidite ve mortalite oranları ile önemli bir sorun olmaya devam etmektedir. EYD, parakrin veya vazokrin yolaklar ile lokal olarak koroner damarlar ve miyokard ile iletişim kurar. EYD ve KAH arasındaki ilişki iyi bilinmesine rağmen, EYD'nin SVGH üzerindeki etkisi hakkında yeterli bilgi yoktur. Bu nedenle EYD ve SVGH arasındaki ilişkiyi araştırmayı amaçladık. YÖNTEM ve GEREÇLER: Çalışma popülasyonu, KABG cerrahisinden bir yıldan fazla bir süre sonra elektif KAG uygulanan 124 ardışık hastadan oluşmaktaydı. Hastalar SVG açıklığının derecesine göre iki gruba ayrıldı. EYD kalınlığı ölçümleri, parasternal uzun ve kısa eksenlerden sağ ventrikülün serbest duvarına çizilen çizgilere dik olan düşük ekojenik yoğunluk alanından belirlendi. BULGULAR: EYD kalınlığı SVGH (+) grubunda SVGH (-) grubuna göre anlamlı olarak daha yüksekti (p

Epicardial Adipose Tissue Thickness and Its Relationship With The Pathophysiology of Saphenous Vein Graft Disease

INTRODUCTION: Despite technical and medical advances,SVGD remains a significant problem that is associated withhigh morbidity and mortality rates. EAT communicates locallywith coronary vessels and myocardium through paracrine orvasocrine pathways. Although the relationship between EATand CAD is well known, there is not sufficient informationabout effect of EAT on SVGD. Therefore, we aimed toinvestigate the relationship between EAT and SVGD.METHODS: The study population consisted of 124consecutive patients who underwent elective CAG more thanone year after CABG surgery. The patients were divided intotwo groups depending on the extent of SVG patency. EATthickness measurements were determined from the lowechogenic density area perpendicular to lines drawn from theparasternal long and short axes to the free wall of the rightventricle.RESULTS: EAT thickness was significantly higher in theSVGD (+) group than in the SVGD (-) group (p < 0.001). Themultivariate logistic regression models revealed that EATthickness (p < 0.001, Odds ratio (OR) = 3.65, 95% Confidenceinterval (C.I.) = 2.52–8.12) was found to be independent factorfor predicting SVG stenosis. An EAT thickness value of > 7.4mm has 86.4 % sensitivity, 69.1 % specificity for the predictionof SVG stenosis.DISCUSSION AND CONCLUSION: EAT thickness is relatedto the presence of SVG stenosis. EAT thickness therefore couldserve as an easily measurable non-invasive adjunctive markerto classical risk factors for the prediction of SVG stenosis.

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