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좌심실의 이완기장애와 심장외막지방두께와의 연관성 연구

Association of Left Ventricular Diastolic Dysfunction and Epicardial Adipose Tissue

  • 김선화 (화명일신기독병원 영상의학과) ;
  • 강세식 (부산가톨릭대학교 방사선학과) ;
  • 김정훈 (부산가톨릭대학교 방사선학과)
  • Kim, Sun-Hwa (Department of Radiological Science, HwaMyeongIlsinchristian Hospital) ;
  • Kang, se-sik (Department of Radiological Science, Catholic University of Pusan) ;
  • Kim, Jung-Hoon (Department of Radiological Science, Catholic University of Pusan)
  • 투고 : 2016.10.11
  • 심사 : 2016.11.30
  • 발행 : 2016.11.30

초록

좌심실 이완기능 장애는 심근허혈이나 좌심실비대 등과 같은 심근질환이 잇는 환자에서 대부분 관찰되지만 심장질환이 없는 건강한 사람에서도 흔하게 관찰된다. 정상 심박출(수축기능)상태에서 좌심실의 이완기 장애 평가는 심부전의 진행과 예후에 영향을 줄 수 있다. 심장외막지방조직은 생리활성분자를 생성하는 대사활동기관으로 심혈관질환에 직접적으로 연관성이 있으며 이는 심근에 직접적으로 영향을 미쳐 이후 심장의 기능장애를 초래한다. 본 연구목적은 심장외막지방의 두께를 측정하여 정상의 수축기 기능인 상태에서 확장기(이완기) 기능장애의 평가와의 연관성을 연구하고자하였다. 연구결과 심장외막지방두께와 이완기 장애 유무가 통계적으로 유의한 수준에서 높은 연관성이 있는 것으로 분석되었다. 특히 심장외막지방두께 측정단면 EAT2에서 측정된 값과 이완기 장애평가방법 E'는 높은 상관관계가 있는 것으로 나타났다. 따라서 심장외막지방두께변화는 좌심실의 이완기능장애를 평가할 수 있는 예측인자로 사용될 수 있을 것으로 사료된다.

Left ventricular diastolic dysfunction is mostly observed in patients with cardiac disease, such as myocardial ischemia or LVH, but linking is usually observed in healthy people without heart disease. Evaluation of left ventricular diastolic failure in normal cardiac output(systolic function) conditions can affect the progress and prognosis of heart failure. The direct relevance to the epicardial adipose tissue metabolism in cardiovascular engine for generating a bioactive moleculer, which leads to dysfunction of the later had a direct effect on myocardial heart. The purpose of this study is to measure the thickness of the epicardial adipose tissue was to study the relevance of the assessment of diastolic dysfunction in systolic function in normal conditions. Results epicardial adipose tissue thickness and diastolic dysfunction was analyzed to have a high correlation in a statistically significant level. In particular, the epicardial adipose tissue thickness measured at the measuring section EAT2 and diastolic function evaluation E' was found to have a high correlation. Thus epicardial adipose tissue thickness variation is believed can be used as a predictor to evaluate the left ventricular diastolic dysfunction.

키워드

참고문헌

  1. Salmasi Abdul-Majeed, Alimo Audrey, Jepson Ewart, Dancy Mark, "Age-associated changes in left ventricular diastolic function are related to increased left ventricular mass," American Journal Hypertension, Vol. 16, No. 6, pp.473-477, 2003. https://doi.org/10.1016/S0895-7061(03)00846-X
  2. S. H. Cho, "Evaluation of Diastolic Function by Tissue Doppler imaging in Normal Healthy Adults >70 Years of Age," Department of Medicine Graduate School, Dong-A University Busan, Korea, 2007.
  3. Senni Michele, Rodeheffer Richard J, Tribouilloy Christophe M, Evans Jonathan M, Jacobsen Steven J, Bailey Kent R, Redfield Margaret M, "Use of echocardiography in the management of congestive heart failure in the community," Journal of the American college of Cardiology Vo. 33 No. 1, pp. 164-170, 1998. https://doi.org/10.1016/S0735-1097(98)00523-3
  4. Gianluca Iacobellis, Domenico Corra, Arya M Sharma, "Epicardial adipose tissue: anatomical, biomolecular and clincial relation to the heart," Nature Clinical Practice. Cardiovascular Medicine, Vol. 2, No. 10, pp. 536-543, 2005. https://doi.org/10.1038/ncpcardio0319
  5. Patricia Iozzo, MD, PHD, " Myocardial, perivascular, and Epicardial Fat," American Diabetes Association, Vol. 34, No. 2, pp. 371-379, 2011.
  6. Heather M. Prendergast, Samuel Dudley, Michael Brown, Martha Daviglus, John Kane, E. Bradshaw Bunney, Jared Marcucci, Rasheed Sanyaolu, "Antihypertnesive Medications and Diastolic Dysfunction Progression in an African American Population," High Blood Pressure&Cardiovascular Prevention, Vol. 21 No. 4, pp. 269-274, 2014. https://doi.org/10.1007/s40292-014-0064-1
  7. Roberto M. Lang, Michelle Bierig, Richard B. Devereux, Frank A. Flachskampf, Elyse Foster, Patricia A. Pellikka, Michael H. Picard, Mary J. Roman, James Seward, Jack Shanewise, Scott Solomon, Kirk T. Spencer, Martin St. John Sutton, William Stewart, "Recommendations for chamber quantification: A report from the American society of Echocardiography's Guidelines and Standards Committe and the Chamber Quantification Writing Group, developed in conjunction with the European Assoication of Echocardiography, Abranch of the European Society of Cardiology," Journal of American society Echocardiogram, Vol. 18, pp. 1440-1463, 2005. https://doi.org/10.1016/j.echo.2005.10.005
  8. Ahmed H. Kissebah, Nadarajen Vydelingum, Robert Murray, David J. Evans, Ronald K. Kalkhoff, Peter W. Adams, " Relation of body fat distribution to Metabolic Complications of obesity," The journal of clinical endocrinology&metabolism, Vol. 54, No. 2, pp. 254-260, 1982. https://doi.org/10.1210/jcem-54-2-254
  9. Gianluca Iacobellis, Maria Cristian Ribaudo, Filippo Assael, Elio Vecci, Claudio Tiberti, Alessandra Zappaterreno, Umberto Di Mario, Frida Leonetti, "Echocardiographic Epicardial Adipose Tissue is Related to Antoropometric and Clinical parameters of Metabolic Syndrome: A new Indicator of Cardiovascular Risk," The Journal of clinical Endocrinology&Metabolism, Vol. 88, No. 11, pp. 5163-5168, 2003. https://doi.org/10.1210/jc.2003-030698
  10. S. H. Kim, J. H. Kim, C. S. Kim, "Risk analysis of factos for metabolic diseases according to the epicardial adipose tissue thickness-which focused on the presented subjects with asymtomatic screening purposes," The korea contents association, Vol. 16, No. 7, pp. 476-483, 2016.
  11. Gianluca Iacobellis, Filippo Assael, Maria Cristina Ribaudo, Alessandra Zappaterreno, Giuseppe Alessi, Umberto Di Mario, Frida Leonetti, "Epicardial Fat from Echocardiogrphy: A New Method for Visceral Adipose Tissue Prediction," Obesity a research journal, Vol. 11, No. 2, pp. 304-310, 2003. https://doi.org/10.1038/oby.2003.45
  12. Joao L. Cavalcante, MD, Balaji K. Tamarappoo, MD, PhD, Rory Hachamovitch, MD, MSc, Deborah H. Kwon, MD, M. Chadi Alraies, MD, Sandra Halliburton, PhD, Paul Schoenhagen, MD, Damini Dey, Daniel S. Berman, MD, and Thomas H. Marwick, MD, PhD, MPH, "Assoication of Epicardial Fat, Hypertension, Subclinical Coronary Artery Disease, and Metabolic Syndrome With Left Ventricular Diastolic Dysfunction," Journal of Cardiology, Vol. 110, No. 12, pp. 1793-1798, 2012.
  13. S. J. Bae, "Studies for B-type Natriuretic Peptide values and association with diastolic echocardiographic parameters," Department of Biomedical Laboratory science The Graduate School Kyungwoon University, 2015.
  14. Ramachandran S. Vasan, MD, Emelia J. Benjamin, MD, ScM, FACC, Daniel Levy, MD, FACC, "Prevalence, clinical features and prognosis of diastolic heart failure: An epidemiologic perspective," Journal of The American college of Cardiology, Vol. 26, No. 7, pp. 1565-1574, 1995. https://doi.org/10.1016/0735-1097(95)00381-9
  15. Masaaki Konishi, MD, Seigo Sugiyama, MD, FJCC, Koichi Sugamura, MD, Toshimitsu Nozaki, MD, Junichi Matsubara, MD, Eiichi Akiyama, MD, Daisuke Utsunomiya, MD, Yasushi Matsuzawa, MD, Yasuyuki Yamashita, MD, Kazuo Kimura, MD, FJCC, Satoshi Umemura, MD, FJCC, Hisao Ogawa, MD, FJCC, "Accumulation of pericardial fat correlates with left ventricular diastolic dysfunction in patients with normal ejection fraction," Journal of Cardiology, Vol. 59, No. 3, pp. 344-351, 2012. https://doi.org/10.1016/j.jjcc.2012.01.006
  16. Assi Milwidsky, Elad Maor, Shaye Kivity, Anat Berkovitch, Sagit Ben zdkry, Alexander Tenenbaum, Enrique Z. Fisman, Aharon Erez, Shlomo Segev, Yechezkel Sidi, ilan Goldengerg, Rafael Kuperstein, "Impaired fasting glucose and left ventricular diastolic dysfunction in middle-age adults: a retrospective cross-sectional analysis of 2971 subjects," Cardiovascular Diabetology, Vol. 14, NO. 119, pp. 1475-1484, 2015.
  17. Hiroyoshi Hirayama, MD, Masahiro Sugano, MD, Nobuyuki Abe, MD, Hidetoshi Yonemochi, MD, Naoki Makino, MD, "Determination of Left ventricular Mass by Echocardiography in Normotensive Diabetic Patients," Japaness Circulation Journal, Vol. 64, No. 12, pp. 921-924, 2000. https://doi.org/10.1253/jcj.64.921
  18. J. Y. Jung, "Clinical parameters of left ventricular diastolic dysfunction in patients with type 2 diabetes mellitus," Department of Medicine The graduate School Yonsei University, 2003.