Is echocardiographic epicardial fat thickness increased in patients with coronary artery disease? A systematic review and meta-analysis.

Electronic Physician Pub Date : 2018-09-09 eCollection Date: 2018-09-01 DOI:10.19082/7249
Mohammad Ali Ansari, Mohsen Mohebati, Farid Poursadegh, Mahdi Foroughian, Alireza Sepehri Shamloo
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引用次数: 13

Abstract

Background: The relation of epicardial fat thickness (EFT) to coronary artery disease (CAD) has recently been reported in multiple studies. Echocardiography is a safe and relatively inexpensive and accessible approach to assess regional EFT, which can be performed easily in many centers.

Objective: To determine the association between echocardiographic EFT and the presence or the absence of CAD.

Methods: This was a systematic review and meta-analysis conducted on literature available in electronic databases up to March 2018. The articles measuring EFT by echocardiography in the right ventricular (RV) free wall were included in the study. The quality of the enrolled items was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The analyses were performed using the Comprehensive Meta-Analysis version 2 software. Cochran's Q test and I2 index were used to evaluate heterogeneity.

Results: This meta-analysis was performed on 13 studies involving 2,436 patients (1,622 with CAD, and 814 without CAD). The maximum EFT reported by echocardiography was 12.9±2.7 mm in the CAD group and 8.4±2.5 mm in the non-CAD group. The minimum EFT reported by echocardiography was 2.2±1.8 mm in the CAD group and 1.8±1.4 mm in the non-CAD group. The heterogeneity was found among the researched studies (I2=91.8%, p=0.000, Q-value=146.43, df [Q] =12) using the random effect model. The patients with CAD had a significantly higher echocardiographic EFT than those without CAD (SMD=1.03, 95% CI= 0.70-1.37, p=0.000).

Conclusion: According to the findings of this meta-analysis, the echocardiographic EFT in the subjects with CAD was significantly higher than that of those without CAD. The measurement of echocardiographic EFT seems to be an acceptable strategy for risk stratification of heart diseases considering ease of use, cost-effectiveness and non-exposure characteristics, compared to other imaging interventions.

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超声心动图显示冠心病患者心外膜脂肪厚度增加吗?系统回顾和荟萃分析。
背景:最近有多项研究报道了心外膜脂肪厚度(EFT)与冠状动脉疾病(CAD)的关系。超声心动图是一种安全且相对便宜的评估局部EFT的方法,在许多中心都可以很容易地进行。目的:探讨超声心动图EFT与冠心病存在与否的关系。方法:对电子数据库中截至2018年3月的文献进行系统综述和荟萃分析。本研究纳入了超声心动图测量右心室游离壁EFT的文章。采用非随机研究方法学指标(未成年人)检查表对入选项目的质量进行评估。使用综合meta分析软件2进行分析。采用Cochran’s Q检验和I2指数评价异质性。结果:本荟萃分析纳入了13项研究,涉及2,436例患者(1,622例CAD, 814例非CAD)。超声心动图显示,冠心病组EFT最大值为12.9±2.7 mm,非冠心病组EFT最大值为8.4±2.5 mm。超声心动图显示冠心病组最小EFT为2.2±1.8 mm,非冠心病组最小EFT为1.8±1.4 mm。采用随机效应模型分析各研究间存在异质性(I2=91.8%, p=0.000, Q值=146.43,df [Q] =12)。冠心病患者超声心动图EFT明显高于非冠心病患者(SMD=1.03, 95% CI= 0.70 ~ 1.37, p=0.000)。结论:本荟萃分析结果显示,冠心病患者的超声心动图EFT明显高于非冠心病患者。与其他成像干预相比,考虑到易用性、成本效益和非暴露特性,超声心动图EFT测量似乎是心脏病风险分层的一种可接受的策略。
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