vestarВестник аритмологииJournal of Arrhythmology1561-86412658-7327НАО «Инкарт»10.35336/VA-1461vestar-1529Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL ARTICLESАссоциация компьютерно-томографических характеристик эпикардиальной жировой ткани с биомаркерами крови у больных с фибрилляцией предсердийRelationship between epicardial adipose tissue characteristics measured by multidetector computed tomography and blood biomarkers in patients with atrial fibrillationhttps://orcid.org/0000-0003-2799-3260СазоноваС. И.SazonovaS. I.

Сазонова Светлана Ивановна 

Томск, ул. Киевская, д. 111А 

Sazonova Svetlana 

Tomsk, 111A Kiyevskaya str. 

sazonova_si@mail.ruhttps://orcid.org/0000-0003-0772-6042ПоповЕ. В.PopovE. V.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0002-8689-8493МосковскихТ. В.MoskovskihT. V.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0002-8649-3648ИльюшенковаЮ. Н.IlyushenkovaYu. N.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0002-0193-9453ВарламоваЮ. В.VarlamovaYu. V.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0003-1415-3932БаталовР. Е.BatalovR. E.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0002-3147-3025ГусаковаА. М.GusakovaA. M.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0002-1235-9956КравченкоЕ. С.KravchenkoE. S.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

https://orcid.org/0000-0002-9050-4493ПоповС. В.PopovS. V.

Томск, ул. Киевская, д. 111А 

Tomsk, 111A Kiyevskaya str. 

НИИ кардиологии - филиал ФГБНУ «Томский национальный исследовательский медицинский центр Российской академии наук»РоссияCardiology Research Institute, Federal State Budgetary Scientific Institution «Tomsk National Research Medical Center of the Russian Academy of Sciences»Russian Federation202513062025322511Copyright © Сазонова С.И., Попов Е.В., Московских Т.В., Ильюшенкова Ю.Н., Варламова Ю.В., Баталов Р.Е., Гусакова А.М., Кравченко Е.С., Попов С.В., 20252025Сазонова С.И., Попов Е.В., Московских Т.В., Ильюшенкова Ю.Н., Варламова Ю.В., Баталов Р.Е., Гусакова А.М., Кравченко Е.С., Попов С.В.Sazonova S.I., Popov E.V., Moskovskih T.V., Ilyushenkova Y.N., Varlamova Y.V., Batalov R.E., Gusakova A.M., Kravchenko E.S., Popov S.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestar.elpub.ru/jour/article/view/1529Цель

Цель. Оценка ассоциации компьютерно-томографических характеристик (объем и плотность) эпикардиальной жировой ткани (ЭЖТ) с концентрацией адипокинов, провоспалительных цитокинов и катехоламинов крови больных с фибрилляцией предсердий (ФП).

Материал и методы исследования. Проспективно в исследование было включено 32 пациента (медиана возраста 58,5 (52,5; 64) года; 18 мужчин) с ФП, запланированных на радиочастотную аблацию аритмии. Всем пациентам была проведена мультиспиральная компьютерно-томографическая коронароангиография и выполнена сегментация ЭЖТ. Кроме того, методом иммуноферментного анализа определена концентрация адипонектина, лептина, резистина, интерлейкинов 1β, 6, 8 и метанефрина в крови.

Результаты

Результаты. По результатам исследования была установлена отрицательная корреляционная взаимосвязь между объемом и плотностью ЭЖТ (r=-0,5, p<0,05). Рентгенологическая плотность ЭЖТ отрицательно коррелировала с концентрацией метанефрина (r=-0,4) и лептина (r=-0,4), а также положительно коррелировала с концентрацией интерлейкина-8 (r=0,36). Кроме того, длительность ФП была отрицательно взаимосвязана с плотностью ЭЖТ (r=-0,42, p<0,05) и положительно взаимосвязана с концентрацией метанефрина крови (r=0,34, p<0,05). Каких-либо ассоциаций между объемом ЭЖТ и исследованными биомаркерами выявлено не было.

Заключение

Заключение. Результаты проведенной работы показали наличие ассоциации между показателем рентгенологической плотности ЭЖТ и концентрацией лептина, интерлейкина-8 и метанефрина у больных с ФП.

Aim

Aim. To evaluate the association of computed tomography measurements (volume and density) of epicardial adipose tissue (EAT) with the blood concentration of adipokines, proinflammatory cytokines and catecholamines in patients with atrial fibrillation (AF).

Methods

Methods. We included 32 patients (median age 58.5 (52.5; 64.0); 18 men) with AF scheduled for radiofrequency ablation. All patients underwent multispiral computed tomographic coronary angiography and segmentation of the EAT. In addition, the concentration of adiponectin, leptin, resistin, interleukins 1b, 6, 8 and methanephrine in the blood was determined by enzyme immunoassay.

Results

Results. А negative correlation was established between the volume and the density of EAT (r= - 0.5, p<0.05). The X-ray density of EAT negatively correlated with the concentration of methanephrine (r= -0.4) and leptin (r= -0.4), and positively correlated with the concentration of interleukin-8 (r=0.36). In addition, the duration of AF was negatively correlated with the density of EAT (r=-0.42, p<0.05) and positively correlated with the concentration of blood methanephrine (r=0.34, p<0.05). No associations were found between the volume of EAT and the studied blood biomarkers.

Conclusion

Conclusion. The results of the study showed an association between EAT X-ray density and the concentration of leptin, interleukin-8 and metanephrine in AF patients.

фибрилляция предсердийэпикардиальная жировая тканькомпьютерная томографиярентгенологическая плотностьметанефринбиомаркеры кровиatrial fibrillationepicardial adipose tissuecomputed tomographyX-ray densitymetanephrineblood biomarkersReferencesGaborit B, Sengenes C, Ancel P, et al. Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat? Compr Physiol. 2017;7(3): 1051-1082. https://doi.org/10.1002/cphy.c160034.Gaborit B, Sengenes C, Ancel P, et al. Role of Epicardial Adipose Tissue in Health and Disease: A Matter of Fat? Compr Physiol. 2017;7(3): 1051-1082. https://doi.org/10.1002/cphy.c160034.Iacobellis G. Epicardial fat links obesity to cardiovascular diseases. Prog Cardiovasc Dis. 2023;78: 27-33. https://doi.org/10.1016/j.pcad.2023.04.006.Iacobellis G. Epicardial fat links obesity to cardiovascular diseases. Prog Cardiovasc Dis. 2023;78: 27-33. https://doi.org/10.1016/j.pcad.2023.04.006.Мустафина ИА, Долганов АА, Кутлубаев МА., Загидуллин НШ. Взаимосвязь эпикардиальной жировой ткани и метаболического синдрома. Артериальная гипертензия. 2023;29(2): 186-193. https://doi.org/10.18705/1607-419X-2023-29-2-186-193.Mustafina IA, Dolganov AA, Kutlubaev М.., Zagidullin NSh. The relationship of epicardial adipose tissue and metabolic syndrome. “Arterial’naya Gipertenziya” (“Arterial Hypertension”). 2023;29(2)186-193. (In Russ.) https://doi.org/10.18705/1607-419X-2023-29-2-186-193.Conte M, Petraglia L, Cabaro S, et al. Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation. Front Cardiovasc Med. 2022;9: 932262. https://doi.org/10.3389/fcvm.2022.932262.Conte M, Petraglia L, Cabaro S, et al. Epicardial Adipose Tissue and Cardiac Arrhythmias: Focus on Atrial Fibrillation. Front Cardiovasc Med. 2022;9: 932262. https://doi.org/10.3389/fcvm.2022.932262.Ernault AC, Meijborg VMF, Coronel R. Modulation of Cardiac Arrhythmogenesis by Epicardial Adipose Tissue: JACC State-of-the-Art Review. J Am Coll Cardiol. 2021;78(17): 1730-1745. https://doi.org/10.1016/j.jacc.2021.08.037.Ernault AC, Meijborg VMF, Coronel R. Modulation of Cardiac Arrhythmogenesis by Epicardial Adipose Tissue: JACC State-of-the-Art Review. J Am Coll Cardiol. 2021;78(17): 1730-1745. https://doi.org/10.1016/j.jacc.2021.08.037.Мустафина ИА, Ионин ВА, Долганов АА, и др. Роль эпикардиальной жировой ткани в развитии сердечно-сосудистых заболеваний. Российский кардиологический журнал. 2022;27(S1):4872. https://doi.org/10.15829/1560-4071-2022-4872.Mustafina IA, Ionin VA, Dolganov AA, et al. Role of epicardial adipose tissue in the development of cardiovascular diseases. Russian Journal of Cardiology. 2022;27(1S): 4872. (In Russ.). https://doi.org/10.15829/1560-4071-2022-4872.Плотникова ИВ, Афанасьев СА, Перевозникова ЮЕ, и др. Вклад вегетативной нервной системы в формирование нарушений ритма сердца в детском возрасте (обзор литературы). Сибирский журнал клинической и экспериментальной медицины. 2023;38(2): 23-29 https://doi.org/10.29001/2073-8552-2023-38-2-23-29.Plotnikova IV, Afanasiev SA, Perevoznikova YuE, et al. The effect of the autonomic nervous system on the formation of cardiac arrhythmias in childhood (review). Siberian Journal of Clinical and Experimental Medicine. 2023;38(2): 23-29. (In Russ.). https://doi.org/10.29001/2073-8552-2023-38-2-23-29.Balcioğlu AS, Çiçek D, Akinci S, et al. Arrhythmogenic evidence for epicardial adipose tissue: heart rate variability and turbulence are influenced by epicardial fat thickness. Pacing Clin Electrophysiol. 2015;38(1): 99-106. https://doi.org/10.1111/pace.12512.Balcioğlu AS, Çiçek D, Akinci S, et al. Arrhythmogenic evidence for epicardial adipose tissue: heart rate variability and turbulence are influenced by epicardial fat thickness. Pacing Clin Electrophysiol. 2015;38(1): 99-106. https://doi.org/10.1111/pace.12512.Romanov A, Minin S, Nikitin N, et al. The relationship between global cardiac and regional left atrial sympathetic innervation and epicardial fat in patients with atrial fibrillation. Ann Nucl Med. 2021;35(10): 1079-1088. https://doi.org/10.1007/s12149-021-01643-2.Romanov A, Minin S, Nikitin N, et al. The relationship between global cardiac and regional left atrial sympathetic innervation and epicardial fat in patients with atrial fibrillation. Ann Nucl Med. 2021;35(10): 1079-1088. https://doi.org/10.1007/s12149-021-01643-2.Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5): 373-498. https://doi.org/10.1093/eurheartj/ehaa612.Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5): 373-498. https://doi.org/10.1093/eurheartj/ehaa612.Abbara S, Blanke P, Maroules CD, et al. SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr. 2016;10(6): 435-449. https://doi.org/10.1016/j.jcct.2016.10.002.Abbara S, Blanke P, Maroules CD, et al. SCCT guidelines for the performance and acquisition of coronary computed tomographic angiography: A report of the society of Cardiovascular Computed Tomography Guidelines Committee: Endorsed by the North American Society for Cardiovascular Imaging (NASCI). J Cardiovasc Comput Tomogr. 2016;10(6): 435-449. https://doi.org/10.1016/j.jcct.2016.10.002.Prokop M, Galansky M., et al. Spiral and Multislice Computed Tomography of the Body. Thieme. 2003. https://doi.org/10.1055/b-0034-79234.Prokop M, Galansky M., et al. Spiral and Multislice Computed Tomography of the Body. Thieme. 2003. https://doi.org/10.1055/b-0034-79234.Чернина ВЮ, Писов МЕ, Беляев МГ, и др. Волюметрия эпикардиальной жировой ткани: сравнение полуавтоматического измерения и алгоритма машинного обучения. Кардиология. 2020;60(9): 46-54. https://doi.org/10.18087/cardio.2020.9.n1111.Chernina VY, Pisov ME, Belyaev MG, et al. Epicardial fat Tissue Volumetry: Comparison of Semi-Automatic Measurement and the Machine Learning Algorithm. Kardiologiia. 2020;60(9): 46- 54. (In Russ.). https://doi.org/10.18087/cardio.2020.9.n1111.Ciuffo L, Nguyen H, Marques MD, et al. Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome. Circ Cardiovasc Imaging. 2019;12(6): e008764. https://doi.org/10.1161/CIRCIMAGING.118.008764.Ciuffo L, Nguyen H, Marques MD, et al. Periatrial Fat Quality Predicts Atrial Fibrillation Ablation Outcome. Circ Cardiovasc Imaging. 2019;12(6): e008764. https://doi.org/10.1161/CIRCIMAGING.118.008764.Al Chekakie MO, Welles CC, Metoyer R, et al. Pericardial fat is independently associated with human atrial fibrillation. J Am Coll Cardiol. 2010;56(10): 784-8. https://doi.org/10.1016/j.jacc.2010.03.071.Al Chekakie MO, Welles CC, Metoyer R, et al. Pericardial fat is independently associated with human atrial fibrillation. J Am Coll Cardiol. 2010;56(10): 784-8. https://doi.org/10.1016/j.jacc.2010.03.071.Huber AT, Fankhauser S, Wittmer S, et al. Epicardial adipose tissue dispersion at CT and recurrent atrial fibrillation after pulmonary vein isolation. Eur Radiol. 2024;34(8): 4928-4938. https://doi.org/10.1007/s00330- 023-10498-2.Huber AT, Fankhauser S, Wittmer S, et al. Epicardial adipose tissue dispersion at CT and recurrent atrial fibrillation after pulmonary vein isolation. Eur Radiol. 2024;34(8): 4928-4938. https://doi.org/10.1007/s00330- 023-10498-2.Nodera M, Ishida T, Hasegawa K, et al. Epicardial adipose tissue density predicts the presence of atrial fibrillation and its recurrence after catheter ablation: three-dimensional reconstructed image analysis. Heart Vessels. 2024;39(8): 696-705. https://doi.org/10.1007/s00380-024-02384-8.Nodera M, Ishida T, Hasegawa K, et al. Epicardial adipose tissue density predicts the presence of atrial fibrillation and its recurrence after catheter ablation: three-dimensional reconstructed image analysis. Heart Vessels. 2024;39(8): 696-705. https://doi.org/10.1007/s00380-024-02384-8.Lake JE, Moser C, Johnston L, et al. CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy. J Clin Endocrinol Metab. 2019;104(10): 4857-4864. https://doi.org/10.1210/jc.2018-02785.Lake JE, Moser C, Johnston L, et al. CT Fat Density Accurately Reflects Histologic Fat Quality in Adults With HIV On and Off Antiretroviral Therapy. J Clin Endocrinol Metab. 2019;104(10): 4857-4864. https://doi.org/10.1210/jc.2018-02785.Takahashi N, Abe I, Kira S, et al. Role of epicardial adipose tissue in human atrial fibrillation. J Arrhythm. 2023;39(2): 93-110. https://doi.org/10.1002/joa3.12825.Takahashi N, Abe I, Kira S, et al. Role of epicardial adipose tissue in human atrial fibrillation. J Arrhythm. 2023;39(2): 93-110. https://doi.org/10.1002/joa3.12825.Ishii Y, Abe I, Kira S, et al. Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation. Heart Rhythm O2. 2021;2(4): 311-323. https://doi.org/10.1016/j.hroo.2021.05.006.Ishii Y, Abe I, Kira S, et al. Detection of fibrotic remodeling of epicardial adipose tissue in patients with atrial fibrillation: Imaging approach based on histological observation. Heart Rhythm O2. 2021;2(4): 311-323. https://doi.org/10.1016/j.hroo.2021.05.006.Sazonova SI, Ilushenkova JN, Batalov RE, et al. Plasma markers of myocardial inflammation at isolated atrial fibrillation. J Arrhythm. 2018;34(5): 493-500. https://doi.org/10.1002/joa3.12083.Sazonova SI, Ilushenkova JN, Batalov RE, et al. Plasma markers of myocardial inflammation at isolated atrial fibrillation. J Arrhythm. 2018;34(5): 493-500. https://doi.org/10.1002/joa3.12083.Тарасова ИВ, Вёрткин АЛ. Роль эпикардиальной жировой ткани в развитии фибрилляции предсердий: обзор литературы. Лечащий Врач. 2024;7(27): 17-22. https://doi.org/10.51793/OS.2024.27.7.002.ТTarasova IV, Vertkin AL. The role of epicardial adipose tissue in the development of atrial fibrillation: a literature review. Lechaschi Vrach. 2024;7(27): 17-22. (In Russ.). https://doi.org/10.51793/OS.2024.27.7.002.Кошельская ОА, Нарыжная НВ, Кологривова ИВ, и др. Взаимосвязь гипертрофии эпикардиальных адипоцитов с адипокинами, воспалением и метаболизмом глюкозы и липидов. Сибирский журнал клинической и экспериментальной медицины. 2023;38(1): 64-74. https://doi.org/10.29001/2073-8552-2023-38-1-64-74.Koshelskaya OA, Naryzhnaya NV, Kologrivova IV, et al. Correlation of epicardial adipocytes hypertrophy with adipokines, inflammation and glucose and lipid metabolism. Siberian Journal of Clinical and Experimental Medicine. 2023;38(1): 64-74. (In Russ.). https://doi.org/10.29001/2073-8552-2023-38-1-64-74.Sazonova SI, Varlamova JV, Nikitin NA, et al. Cardiac 123I-mIBG scintigraphy for prediction of catheter ablation outcome in patients with atrial fibrillation. J Nucl Cardiol. 2022;29(5): 2220-2231. https://doi.org/10.1007/s12350-021-02658-y.Sazonova SI, Varlamova JV, Nikitin NA, et al. Cardiac 123I-mIBG scintigraphy for prediction of catheter ablation outcome in patients with atrial fibrillation. J Nucl Cardiol. 2022;29(5): 2220-2231. https://doi.org/10.1007/s12350-021-02658-y.Akutsu Y, Kaneko K, Kodama Y, et al. Iodine-123 mIBG Imaging for Predicting the Development of Atrial Fibrillation. JACC Cardiovasc Imaging. 2011;4(1): 78-86. https://doi.org/10.1016/j.jcmg.2010.10.005.Akutsu Y, Kaneko K, Kodama Y, et al. Iodine-123 mIBG Imaging for Predicting the Development of Atrial Fibrillation. JACC Cardiovasc Imaging. 2011;4(1): 78-86. https://doi.org/10.1016/j.jcmg.2010.10.005.Arimoto T, Tada H, Igarashi M, et al. High washout rate of iodine-123-metaiodobenzylguanidine imaging predicts the outcome of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(12): 1297-304. https://doi.org/10.1111/j.1540-8167.2011.02123.x.Arimoto T, Tada H, Igarashi M, et al. High washout rate of iodine-123-metaiodobenzylguanidine imaging predicts the outcome of catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol. 2011;22(12): 1297-304. https://doi.org/10.1111/j.1540-8167.2011.02123.x.Polat F, Ko AL. Comparison of Patients with Atrial Fibrillation Without Structural Heart Disease and Normal Population In Terms of Urine Catecholamines. Turk Kardiyol Dern Ars. 2023;51(3): 168-173. English. https://doi.org/10.5543/tkda.2022.16281.Polat F, Ko AL. Comparison of Patients with Atrial Fibrillation Without Structural Heart Disease and Normal Population In Terms of Urine Catecholamines. Turk Kardiyol Dern Ars. 2023;51(3): 168-173. English. https://doi.org/10.5543/tkda.2022.16281.Kanorskii SG. Epicardial Adipose Tissue and Cardiac Arrhythmias. Cardiac Arrhythmias. 2022;2(2): 5-18. https://doi.org/10.17816/cardar107112.Kanorskii SG. Epicardial Adipose Tissue and Cardiac Arrhythmias. Cardiac Arrhythmias. 2022;2(2): 5-18. https://doi.org/10.17816/cardar107112.Лосик ДВ, Никитин НА, Минин СМ, и др. Роль эпикардиальной жировой ткани и автономной нервной системы в патогенезе нарушений ритма сердца. Патология кровообращения и кардиохирургия. 2021;25(3): 27-33. https://doi.org/10.21688/1681-3472-2021-3-27-33.Losik DV, Nikitin NA, Minin SM, et al. The role of epicardial adipose tissue and autonomic nervous system in pathophysiology of cardiac arrhythmias. Patologiya krovoobrashcheniya i kardiokhirurgiya = Circulation Pathology and Cardiac Surgery. 2021;25(3): 27-33. (In Russ.). https://doi.org/10.21688/1681-3472-2021-3-27-33.Джиджихия КМ, Каде АХ, Занин СА, и др. Лептин и артериальная гипертензия при метаболическом синдроме. Успехи современного естествознания. 2013;7: 159.Jijihiya KM, Kade AH, Zanin S A, et al. Leptin and arterial hypertension in metabolic syndrome. The successes of modern natural science. 2013;7: 159. (In Russ.).

The authors declare that there are no conflicts of interest present.