medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-173medsovet-9115Research ArticleИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦАISHEMIC HEART DISEASEПоражение коронарного русла и эпикардиальный жир у лиц с нестабильной стенокардиейCoronary artery damage and epicardial fat in individuals with unstable angina pectorishttps://orcid.org/0000-0003-4194-6823ДавыдоваА. В.DavydovaA. V.

Давыдова Анна Владимировна, врач-кардиолог

115093, Россия, Москва, ул. Большая Серпуховская, д. 16/15 

Anna V. Davydova, Cardiologist

16/15, Bolshaya Serpukhovskaya St., Moscow, 115093, Russia

anna.pustovaya@gmail.comhttps://orcid.org/0000-0001-7862-0937НикифоровВ. С.NikiforovV. S.

Никифоров Виктор Сергеевич, д.м.н., профессор, профессор кафедры функциональной диагностики

191015, Россия, Санкт-Петербург, ул. Кирочная, д. 41 

Viktor S. Nikiforov, Dr. Sci (Med.), Professor, Professor of the Department of Functional Diagnostics 

41, Kirochnaya St., St Petersburg, 191015, Russia

viktor.nikiforov@szgmu.ruПоликлиника 101РоссияPolyclinic 101Russian FederationСеверо-Западный государственный медицинский университет имени И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian Federation20252405202506150157Copyright © Давыдова А.В., Никифоров В.С., 20252025Давыдова А.В., Никифоров В.С.Davydova A.V., Nikiforov V.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9115

Введение. Роль эпикардиального жира в патогенезе атеросклероза и коронарной болезни сердца не теряет своей актуальности. В то же время взаимосвязь толщины эпикардиального жира с нестабильной стенокардией малоизучена.Цель. Изучить взаимосвязь между поражением коронарного русла и толщиной эпикардиального жира у лиц с нестабильной стенокардией.Материалы и методы. В исследование включено 102 пациента, медиана возраста 62 (55; 67) года с нестабильной стенокардией, госпитализированных в ОНК РСЦ Камчатской краевой больницы в 2018 и 2019 гг. Выполнено лабораторное тестирование с определением уровня интерлейкина-6 (ИЛ-6), фактора некроза опухоли альфа (ФНО-альфа), лептина и адипонектина. Стентирование коронарного русла и эхокардиография с измерением толщины эпикардиального жира (ТЭЖ) проведены в первые 3 сут. Участники разделены на 2 группы в зависимости от ТЭЖ: 1-я группа – пациенты с ТЭЖ ≤ 7,6 мм (n = 46); 2-я группа – ТЭЖ > 7,6 мм (n = 56).Результаты. Группы не различались по основным клинико-анамнестическим показателям (пол, возраст, стаж по курению, наличию и длительности гипертонической болезни). У лиц с ТЭЖ > 7,6 мм выявлено повышение процентного содержания жира тела (р = 0,004) и висцерального жира (р = 0,017). Повышение уровня лептина (р = 0,001), С-реактивного белка (р = 0,007), ИЛ-6 (р = 0,001) и ФНО-альфа (р = 0,001), а также общего холестерина (р = 0,023) и липопротеидов низкой плотности (р = 0,002) регистрировалось в группе лиц с ТЭЖ >7,6 мм. Положительные корреляционные связи выявлены между ТЭЖ и ИЛ-6 (ro = 0,589; р = 0,001) и лептином (ro = 0,318; р = 0,002). Многососудистое поражение коронарного русла значимо чаще встречалось в группе с ТЭЖ > 7,6 мм.Заключение. Измерение ТЭЖ в качестве косвенной оценки распространенности коронарного атеросклероза у лиц с нестабильной стенокардией представляется более информативным методом в сравнении с использованием классических показателей кардиометаболического риска.

Introduction. The role of epicardial fat in the pathogenesis of atherosclerosis and coronary heart disease remains relevant. At the same time, the relationship between epicardial fat thickness and unstable angina is poorly understood.Aim. To study the relationship between coronary artery disease and epicardial fat thickness in individuals with unstable angina pectoris.Materials and methods. The study included 102 patients, 64 men, median age 62 (55; 67) years with unstable angina, who were hospitalized at the Regional Cardiology Center of the Kamchatka Regional Hospital from 2018 to 2019. Laboratory testing was performed to assess the levels of interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), leptin and adiponectin. Coronary artery stenting and echocardiography with measurement of epicardial adipose tissue (EAT) thickness were performed 1-3 days after hospitalization. The participants were divided into 2 groups based on the EAT thickness: Group 1 – patients with EAT thickness <7.6 mm (n = 46); Group 2 – EAT thickness >7.6 mm (n = 56).Results. There were no significant differences between the groups in terms of the main clinical and anamnestic indicators, such as gender, age, smoking history, and the presence and duration of hypertension. However, in individuals with epicardial adipose tissue thickness >7.6 mm, a significant increase in body fat (р = 0,004) and visceral fat was observed (р = 0,017). Additionally, there were significant increases in levels of leptin (р = 0,001), C-reactive protein (р = 0,007), interleukin-6 (р = 0,001), TNF-alpha (р = 0,001), and HDL (р = 0,002). Positive correlations were also found between EAT and IL-6 (ro = 0,589; р = 0,001) and leptin (ro = 0,318; р = 0,002). Multivessel coronary lesions were significantly more common in patients with EAT >7.6 mm.Conclusion. The measurement of epicardial adipose tissue thickness as an indirect assessment of the prevalence of coronary atherosclerosis in patients with unstable angina is a more informative method in comparison with the use of classical indicators of cardiometabolic risk.

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