Толщина эпикардиальной жировой ткани как предиктор желудочковой экстрасистолии

Цель. Эпикардиальная жировая ткань (ЭЖТ) представляет собой слой между миокардом и эпикардом, аналогичный внутрибрюшной жировой ткани. Многие сердечно-сосудистые заболевания связаны с повышенным значением толщины ЭЖТ. Существуют ограниченные доказательства того, что ЭЖТ способствует развитию желудочковой экстрасистолии (ЖЭС). В этом исследовании мы стремились изучить влияние ЭЖТ на развитие ЖЭС.
Материал и методы. В проспективное исследование в период с апреля 2022 г. по март 2023 г. были включены 266 пациентов. Им была проведена электрокардиограмма в 12 отведениях, 24-часовое холтеровское мониторирование ЭКГ и эхокардиография. Пациенты были разделены на две группы: группа с ЖЭС (n=134) (>60 ЖЭС/час) и группа без ЖЭС (n=132) (<10 ЖЭС/час). Кроме того, тяжелая форма ЖЭС определялась как ≥10 000 ЖЭС/24 часа. Толщина ЭЖТ и другие переменные сравнивались между группами без ЖЭС и с ЖЭС. Для выявления факторов, влияющих на ЖЭС, был проведен логистический регрессионный анализ, а для определения пороговых значений переменных использовался ROC-анализ.
Результаты. Толщина ЭЖТ была больше в группе ЖЭС (р<0,001). При попарных сравнениях большее значение ЭЖТ в группе ЖЭС не зависело от частоты желудочковых сокращений (р=0,552). Переменными, влияющими на наличие ЖЭС, были индекс массы миокарда левого желудочка (р=0,031), дисперсия интервала QT (р=0,010) и толщина ЭЖТ (р<0,001). Значение толщины ЭЖТ позволяло предсказывать наличие ЖЭС с чувствительностью 54,5% и специфичностью 81,3% при пороговом значении 4,05.
Выводы. Это исследование показало, что увеличение толщины ЭЖТ может быть независимым предиктором ЖЭС.

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