心衰患者身体成分、心功能、临床指标之间的相关性:基于CT定量测量OA
Correlation between body composition,cardiac function,and clinical indicators in heart failure patients:a CT-based quantitative study
目的 基于CT定量测量不同程度心衰患者的身体成分[皮下脂肪面积(SAT)、内脏脂肪面积(VAT)、骨骼肌面积(SMA)及肌间脂肪组织面积(IMAT)、心外膜脂肪体积(EAT)],探究心衰患者身体成分与临床指标及心功能指标之间的相关性.方法回顾性收集2024年1月～2025年6月在西安交通大学第二附属医院确诊为射血分数降低的心衰(HFrEF)患者以及年龄、性别匹配的射血分数保留的心衰(HFpEF)患者各50例,同时纳入同期来我院进行体检的健康对照50例,所有受试者均行胸部CT平扫及心脏超声检查.使用西门子Syngo.Via工作站于T12椎体层面半自动测量SAT、SMA、IMAT,于T12/L1椎间隙层面半自动测量VAT,通过器官分割心脏自动得到EAT.比较HFpEF、HFrEF患者及对照组临床资料及身体成分的差异,评估HFpEF、HFrEF患者身体成分与临床资料及左心室射血分数、N末端脑钠肽前体的关联性.结果 与HFrEF组比较,HFpEF组IMAT面积增高(P=0.011);与健康对照组比较,HFpEF组VAT面积增高(P=0.025).HFrEF组和健康对照组比较,各脂肪成分的差异无统计学意义(P>0.05).相关性分析表明,HFpEF组IMAT面积与LVEF呈正相关(r=0.455,P=0.011),HFrEF组身体成分指标与LVEF之间无相关性(P>0.05).结论 不同心衰表型在腹部脂肪分布模式及其与心功能的相关性上存在差异,其评估可为心衰的早期分型提供影像学依据.
Objective To quantitatively assess body composition parameters,including subcutaneous adipose tissue area(SAT),visceral adipose tissue area(VAT),skeletal muscle area(SMA),intermuscular adipose tissue area(IMAT),and epicardial adipose tissue volume(EAT)in patients with different heart failure(HF)phenotypes by using CT,and to investigate the correlations between these body composition parameters and clinical indices as well as cardiac function indicators.Methods A retrospective collection was performed on 50 patients diagnosed with heart failure with reduced ejection fraction(HFrEF)and 50 age-and gender-matched patients with heart failure with preserved ejection fraction(HFpEF)at the Second Affiliated Hospital of Xi'an Jiaotong University from January 2024 to June 2025.Additionally,50 healthy controls(HC)who underwent physical examinations at our hospital during the same period were included.All participants underwent non-contrast chest CT and echocardiography.Using a Siemens Syngo.Via workstation,SAT,SMA,and IMAT were semi-automatically measured at the T12 vertebral level,VAT was semi-automatically measured at the T12/L1 intervertebral space,and EAT was automatically obtained via cardiac organ segmentation.Differences in clinical data and body composition among the HFpEF,HFrEF,and control groups were compared,and the associations between body composition parameters and clinical data,left ventricular ejection fraction,and N-terminal pro-brain natriuretic peptide were evaluated in patients with HFpEF and HFrEF.Results Compared to the HFrEF group,the HFpEF group showed a significantly higher IMAT area(P=0.011).Compared to the healthy control group,the HFpEF group exhibited a significantly higher VAT area(P=0.025).No significant differences in body composition were observed between the HFrEF group and the healthy control group(P>0.05).Correlation analysis revealed that in the HFpEF group,IMAT area was significantly positively correlated with LVEF(r=0.455,P=0.011).In the HFrEF group,no significant correlations were found between body composition indicators and LVEF(P>0.05).Conclusion Different heart failure phenotypes exhibit distinct patterns of abdominal fat distribution and different correlations with cardiac function.Assessment of these differences may provide an imaging-based reference for the early phenotyping of heart failure.
陈佩瑶;樊佳怡;代双凤;于寰;雷朝;张月浪;晏乘曦
西安交通大学第二附属医院医学影像科,陕西 西安 710004西安交通大学第二附属医院医学影像科,陕西 西安 710004北京万东医疗科技股份有限公司,北京 100024首都医科大学良乡教学医院医学影像科,北京 102401西安交通大学第二附属医院医学影像科,陕西 西安 710004西安交通大学第二附属医院医学影像科,陕西 西安 710004西安交通大学第二附属医院医学影像科,陕西 西安 710004
心力衰竭计算机断层扫描腹部脂肪左心室射血分数N末端脑钠肽前体
heart failureCTabdominal fatleft ventricular ejection fractionN-terminal pro-brain natriuretic peptide
《分子影像学杂志》 2026 (5)
579-586,8
首都卫生发展科研专项项目(首发2020-4-7073)
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