The Relationship Between Epicardial Adipose Tissue and Insulin Resistance in Obese Children.
- 作者列表："Güneş H","Güneş H","Temiz F
:Background Insulin resistance (IR) is an important disorder in obese children because it is closely related to cardiovascular diseases. Epicardial adipose tissue (EAT) plays a role in the development of IR due to secreted bioactive molecules, and the inflammatory process of these molecules may cause atrial electromechanical delay (EMD). Objective The objective of our study was to determine the relationship between EAT and EMD with IR in obese children. Methods Ninety-four obese patients were included in the study. IR was calculated using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and defined as HOMA-IR greater than the 90thpercentile in an age- and sex-specific percentile curve. Patients were divided into two groups according to their IR. All patients underwent echocardiographic examinations. Statistical significance was set to a two-sided p-value < 0.05. Results EAT was significantly higher in the IR group (p < 0.001). The optimal cut-off value for EAT to predict IR was found to be > 3.85 mm, with 92.5% specificity and 68.5% sensitivity (p = 0.002). In the multivariate logistic regression model, EAT (OR = 1.256, 95% CI: 1.016-1.53, p = 0.035) was also associated with IR after adjustment for variables found to be statistically significant in univariate analysis. Inter- and intra-atrial EMD was significantly prolonged in the IR group compared to the group without IR (p < 0.010; p = 0.032 respectively). Conclusion: In our study, we revealed that EAT was positively correlated with IR and was an independent predictor of IR. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0).
背景: 胰岛素抵抗 (IR) 与心血管疾病密切相关，是肥胖儿童的重要疾病。心外膜脂肪组织 (EAT) 由于分泌的生物活性分子而在IR的发展中起作用，这些分子的炎症过程可能导致心房机电延迟 (EMD)。目的探讨肥胖儿童EAT和EMD与IR的关系。方法94例肥胖患者纳入研究。使用胰岛素抵抗的稳态模型评估 (homa-ir) 计算IR，并定义为homa-ir大于年龄和性别特异性百分位数曲线中的90百分位数。根据IR将患者分为两组。所有患者均行超声心动图检查。统计显著性设定为双侧p值 <0.05。结果IR组EAT显著高于IR组 (p <0.001)。发现EAT预测IR的最佳截止值为> 3.85毫米，具有92.5% 的特异性和68.5% 的灵敏度 (p = 0.002)。在多变量逻辑回归模型中，EAT (OR = 1.256，95% CI: 1.016-1.53，p = 0.035) 也与在单变量分析中发现有统计学意义的变量校正后的IR相关。与无IR组相比，IR组的心房内和心房内EMD显著延长 (分别为p <0.010; p = 0.032)。结论: 在我们的研究中，我们发现EAT与IR呈正相关，是IR的独立预测因子。(Arq Bras Cardiol。2020; [在线]。提前打印，PP.0-0)。
METHODS::We present the case of a 61-year-old woman with a large tumoral infiltration extending from the pelvis throughout the inferior vena cava inferior to the right atrium, protruding into the right ventricle and right ventricular outflow tract. She had been treated 10 years before for low-grade endometrial stromal sarcoma by hysterectomy and adnexectomy followed by hormone- and radio-therapy. Due to cancer recurrence, she underwent peritonectomy, appendectomy, and resection of terminal ileum.
METHODS:AIMS:Significant platelet activation after long stented coronary segments has been associated with periprocedural microvascular impairment and myonecrosis. In long lesions treated either with an everolimus-eluting bioresorbable vascular scaffold (BVS) or an everolimus-eluting stent (EES), we aimed to investigate (a) procedure-related microvascular impairment, and (b) the relationship of platelet activation with microvascular function and related myonecrosis. METHODS AND RESULTS:Patients (n=66) undergoing elective percutaneous coronary intervention (PCI) in long lesions were randomised 1:1 to either BVS or EES. The primary endpoint was the difference between groups in changes of pressure-derived corrected index of microvascular resistance (cIMR) after PCI. Periprocedural myonecrosis was assessed by high-sensitivity cardiac troponin T (hs-cTnT), platelet reactivity by high-sensitivity adenosine diphosphate (hs-ADP)-induced platelet reactivity with the Multiplate Analyzer. Post-dilatation was more frequent in the BVS group, with consequent longer procedure time. A significant difference was observed between the two groups in the primary endpoint of ΔcIMR (p=0.04). hs-ADP was not different between the groups at different time points. hs-cTnT significantly increased after PCI, without difference between the groups. CONCLUSIONS:In long lesions, BVS implantation is associated with significant acute reduction in IMR as compared with EES, with no significant interaction with platelet reactivity or periprocedural myonecrosis.
METHODS:BACKGROUND:Aortopulmonary window is an uncommon congenital heart disease, with untreated cases not surviving beyond childhood. However, very rarely it can present in adult patients with features of pulmonary hypertension. Clinically these patients cannot be differentiated from other more common conditions with left to right shunt. Transthoracic echocardiography if performed meticulously, can depict the defect in aortopulmonary septum. RESULTS:We report a case of large unrepaired aortopulmonary window in a 23 years old patient, diagnosed on transthoracic echocardiography.