rentradВестник рентгенологии и радиологииJournal of radiology and nuclear medicine0042-46762619-0478Limited Liability Company "LUCHEVAYA DIAGNOSTIKA", Russian Association of Radiologists10.20862/0042-4676-2019-100-6-387-394rentrad-521Research ArticleОБЗОРЫREVIEWSРоль количественной оценки висцеральной жировой ткани сердца как предиктора развития сердечно-сосудистых событийThe Role of Quantitative Assessment of Visceral Adipose Tissue of the Heart as a Predictor for Cardiovascular Eventshttps://orcid.org/0000-0002-0302-293XЧернинаВ. Ю.CherninaV. Yu.

Чернина Валерия Юрьевна, мл. науч. сотр.

ул. Средняя Калитниковская, 28, стр. 1, Москва, 109029

Valerya Yu. Chernina, Junior Researcher

ul. Srednyaya Kalitnikovskaya, 28, stroenie 1, Moscow, 109029

chernina909@gmail.comhttps://orcid.org/0000-0001-6545-6170МорозовС. П.MorozovS. P.

Морозов Сергей Павлович, д. м. н., профессор, директор

ул. Средняя Калитниковская, 28, стр. 1, Москва, 109029

Sergey P. Morozov, Dr. Med. Sc., Professor, Director

ul. Srednyaya Kalitnikovskaya, 28, stroenie 1, Moscow, 109029

НизовцоваЛ. А.NizovtsovaL. A.

Низовцова Людмила Арсеньевна, д. м. н., профессор, вед. науч. сотр.

ул. Средняя Калитниковская, 28, стр. 1, Москва, 109029

Lyudmila A. Nizovtsova, Dr. Med. Sc., Professor

ul. Srednyaya Kalitnikovskaya, 28, stroenie 1, Moscow, 109029

https://orcid.org/0000-0002-2681-9378БлохинИ. А.BlokhinI. A.

Блохин Иван Андреевич, мл. науч. сотр.

ул. Средняя Калитниковская, 28, стр. 1, Москва, 109029

Ivan A. Blokhin, Junior Researcher

ul. Srednyaya Kalitnikovskaya, 28, stroenie 1, Moscow, 109029

https://orcid.org/0000-0002-6389-0325СитдиковД. И.SitdikovD. I.

Ситдиков Денис Илдусович, студент лечебного факультета

ул. Средняя Калитниковская, 28, стр. 1, Москва, 109029

Denis I. Sitdikov, Student, I.M. Sechenov First Moscow State Medical University

ul. Srednyaya Kalitnikovskaya, 28, stroenie 1, Moscow, 109029

https://orcid.org/0000-0003-1816-1315ГомболевскийВ. А.GombolevskiyV. A.

Гомболевский Виктор Александрович,к. м. н., руководитель отдела развития качества радиологии 

ул. Средняя Калитниковская, 28, стр. 1, Москва, 109029

Viktor A. Gombolevskiy, Cand. Med. Sc., Head of Department of Development of Quality of Radiology

ul. Srednyaya Kalitnikovskaya, 28, stroenie 1, Moscow, 109029

ГБУЗ «Научно-практический клинический центр диагностики и телемедицинских технологий Департамента здравоохранения города Москвы»РоссияScientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, Department of Health of MoscowRussian Federation2019260120201006387394Copyright © Чернина В.Ю., Морозов С.П., Низовцова Л.А., Блохин И.А., Ситдиков Д.И., Гомболевский В.А., 20202020Чернина В.Ю., Морозов С.П., Низовцова Л.А., Блохин И.А., Ситдиков Д.И., Гомболевский В.А.Chernina V.Y., Morozov S.P., Nizovtsova L.A., Blokhin I.A., Sitdikov D.I., Gombolevskiy V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.russianradiology.ru/jour/article/view/521

C целью оценки возможности визуализации висцеральной жировой ткани сердца с помощью эхокардиографии (ЭхоКГ), компьютерной томографии (КТ) и магнитно-резонансной томографии (МРТ) и систематизации данных о ее физиологической и патофизиологической роли проведен анализ релевантных отечественных и зарубежных источников литературы в научных библиотеках eLIBRARY, PubMed по ключевым словам: «паракардиальный жир», «эпикардиальный жир», «висцеральный жир сердца», «epicardial adipose tissue», «pericardial adipose tissue», «adiopocytokine». Собраны актуальные данные на ноябрь 2018 г. В обзоре представлены современные данные о физиологической и патофизиологической роли цитокинов, секретируемых паракардиальной жировой тканью, а также о корреляции и теориях возможной взаимосвязи объема паракардиальной жировой ткани с развитием ишемической болезни сердца, фибрилляции предсердий и метаболического синдрома. По данным ЭхоКГ, толщина эпикардиальной жировой ткани является достоверным предиктором наличия атеросклеротических бляшек высокого риска в коронарных артериях. Объем жировой ткани с высокой точностью может быть измерен с помощью КТ (ручная, полуавтоматическая и автоматическая методики). Ряд исследований доказывает возможность использования МРТ для поставленных задач.

Современное представление о роли этих жировых депо может потенциально использоваться в оценке риска сердечно-сосудистых заболеваний. Проведённый обзор литературы подтвердил, что висцеральная жировая ткань сердца оказывает непосредственное влияние на миокард и коронарные артерии и может быть количественно оценена с помощью ЭхоКГ, КТ и МРТ. 

Objective of this article – to evaluate possibilities to visualize cardiac visceral adipose tissue by echocardiography, computed tomography (CT), and magnetic resonanse imaging (MRI) and to systematize data on its physiological and pathological roles. To achieve this goal, the authors analyzed relevant Russian and foreign sources of literature in the scientific libraries eLIBRARY and PubMed, by using the keywords: “pericardial fat”, “epicardial fat”, “visceral fat of the heart”, “epicardial adipose tissue”, “pericardial adipose tissue”, and “adipocytokine”. Actual data as of November 2018 were collected. The review presents up-to-date data on the physiological and pathophysiological roles of cytokines secreted by pericardial adipose tissue, as well as on correlations and possible theories of the relationship between the volumes of pericardial adipose tissue and the development of coronary heart disease, atrial fibrillation, and metabolic syndrome. According to echocardiography, epicardial adipose tissue thickness is a reliable predictor for the presence of high-risk atherosclerotic plaques in the coronary arteries. Adipose tissue volume can be measured with high accuracy using CT (manual, semi-automatic, and automatic methods).

A number of studies prove that MRI can be used for assigned tasks. The current notion of the role of these adipose depots can potentially be used in assessing the risk of cardiovascular diseases. The literature review presented confirms that visceral adipose tissue of the heart has a direct effect on the myocardium and coronary arteries and can be quantified using echocardiography, CT and MRI.

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