체성분 분포와 동맥경화성 관상동맥질환의 상관관계

Abstract

Background Obesity is a risk factor for cardiovascular diseases; however, only using body mass index to evaluate obesity is insufficient. The aim of this study was to investigate the relationship between body composition and atherosclerotic coronary artery disease (CAD).

Methods This prospective cohort case-control study included 1,185 patients who underwent coronary angiography between June 30, 2020, and November 5, 2021, at Hanyang University Seoul Hospital. The patients were classified as either CAD or non-CAD groups. CAD was defined as a luminal narrowing > 50% in at least one coronary artery. We compared the baseline characteristics, angiographic findings, body compositions, and echocardiographic data of coronary artery disease (CAD) and non-CAD groups. We further analyzed the components of body composition that could reflect the volume status.

Results Of the total 1,185 patients, 850 were in the CAD group. Of the total patient population, the average age was 65.0 ± 12.0 years, and 772 (65.1%) were men. The CAD group was older and more likely to be men and had more risk factors such as hypertension, diabetes mellitus, chronic kidney disease, and peripheral artery disease. The CAD group had a significantly lower percentile muscle mass (99.1% vs. 100.9%, p=0.005) and significantly higher extracellular water (ECW) ratio (38.6% vs. 38.1%, p=0.001). The prevalence of CAD decreased by 0.82 times decreased with 10% higher percentile muscle mass (0.72-0.94, p=0.003) and increased by 1.08 times with 1% higher ECW ratio (1.01-1.15, p=0.030) per multivariable logistic regression analyses after adjusting for risk factors of cardiovascular diseases. The ECW ratio had a positive linear correlation with early diastolic trans-mitral inflow velocity per tissue Doppler imaging of the mitral-septal annulus diastolic velocity (correlation coefficient, 0.35, p<0.001) and log-transformed brain natriuretic peptide levels (correlation coefficient, 0.51, p<0.001) and a negative linear correlation with left ventricular ejection fraction (correlation coefficient, -0.22, p<0.001).

Conclusion Low muscle mass and high ECW ratio were associated with atherosclerotic CAD, and ECW ratio had a modest correlation with parameters of volume status.