ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12614ometendo-12614Research ArticleОбзор литературыReviewЭпикардиальное ожирение и фибрилляция предсердий: акцент на предсердном жировом депоEpicardial obesity and atrial fibrillation: emphasis on atrial fat depothttps://orcid.org/0000-0002-8879-3791МазурЕвгений СтаниславовичMazurEvgeniy S.

Мазур Евгений Станиславович, д.м.н., профессор, ORCID: https://orcid.org/0000-0002-8879-3791, eLibrary SPIN: 3898-6719. e-mail: mazur-tver@mail.ru

170100, Тверь, ул. Советская, д. 4

Evgeniy S. Mazur, MD, PhD, professor, ORCID: https://orcid.org/0000-0002-8879-3791, eLibrary SPIN: 3898-6719. e-mail: mazur-tver@mail.ru

4 Sovetskaya street, 170100 Tver

mazur-tver@mail.ruhttps://orcid.org/0000-0003-4818-434XМазурВера ВячеславовнаMazurVera V.

Мазур Вера Вячеславовна, д.м.н., ORCID: https://orcid.org/0000-0003-4818-434X, eLibrary SPIN: 9798-0540, e-mail: vera.v.mazur@gmail.com

Vera Vyacheslavovna Mazur, MD, PhD, ORCID: https://orcid.org/0000-0003-4818-434X, eLibrary SPIN: 9798-0540, e-mail: vera.v.mazur@gmail.com

vera.v.mazur@gmail.comhttps://orcid.org/0000-0003-0511-7366БаженовНиколай ДмитриевичBazhenovNikolay D.

Баженов Николай Дмитриевич, к.м.н., ORCID: https://orcid.org/0000-0003-0511-7366, eLibrary SPIN: 1053-3892, e-mail: bazhenovnd@mail.ru

Nikolay D. Bazhenov, MD, PhD, ORCID: https://orcid.org/0000-0003-0511-7366, eLibrary SPIN: 1053-3892, e-mail: bazhenovnd@mail.ru

bazhenovnd@mail.ruhttps://orcid.org/0000-0002-1708-455XКолбасниковСергей ВасильевичKolbasnicovSergey V.

Колбасников Сергей Васильевич, д.м.н., профессор, ORCID: https://orcid.org/0000-0002-1708-455X, eLibrary SPIN: 2127-3801, e-mail: kabinet208@mail.ru

Sergey V. Kolbasnicov, MD, PhD, professor, ORCID: https://orcid.org/0000-0002-1708-455X, eLibrary SPIN: 2127-3801, e-mail: kabinet208@mail.ru

kabinet208@mail.ruhttps://orcid.org/0000-0002-0648-5358НиловаОксана ВладимировнаNilovaOksana V.

Нилова Оксана Владимировна, к.м.н., ORCID: https://orcid.org/0000-0002-0648-5358, eLibrary SPIN: 1881-9917, e-mail: tevirp69@mail.ru

Oksana V. Nilova, MD, PhD, ORCID: https://orcid.org/0000-0002-0648-5358, eLibrary SPIN: 1881-9917, e-mail: tevirp69@mail.ru

tevirp69@mail.ruТверской государственный медицинский университетРоссияTver State Medical UniversityRussian Federation202004122020173316325Copyright © Мазур Е.С., Мазур В.В., Баженов Н.Д., Колбасников С.В., Нилова О.В., 20202020Мазур Е.С., Мазур В.В., Баженов Н.Д., Колбасников С.В., Нилова О.В.Mazur E.S., Mazur V.V., Bazhenov N.D., Kolbasnicov S.V., Nilova O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12614

Исследования, проведенные с применением магнитно-резонансной и компьютерной томографии, показали, что увеличение количества жира, непосредственно прилегающего к миокарду (эпикардиальный жир), сильнее, чем показатели общего и абдоминального ожирения коррелирует с риском развития фибрилляции предсердий и эффективностью процедуры катетерной аблации. По данным ряда исследований, еще более сильным прогностическим значением обладает эпикардиальный жир, покрывающий миокард левого предсердия. Количество предсердного жира связано также с эффективностью кардиоверсии и риском развития кардиоэмболического инсульта у больных фибрилляцией предсердий. Число таких работ невелико, поскольку томографические методики не входят в число показанных при подозрении на предсердное тромбообразование, а трансторакальная эхокардиография не позволяет визуализировать предсердный жир. Однако при обследовании таких больных достаточно широко используется чреспищеводная эхокардиография, позволяющая визуализировать и с высокой точностью измерять структуры, служащие депо эпикардиального жира, а именно, межпредсердную перегородку и левый боковой (кумадинов) гребень. Накопление эпикардиального жира сопровождается увеличением размеров этих структур, что может быть использовано при изучении взаимосвязи между эпикардиальным ожирением и риском развития тромбоэмболических осложнений у больных фибрилляцией предсердий.

The studies, performed with MRI and CT, showed that the increase of fat, immediately adjacent to the myocardium (epicardial fat) is correlated more strongly with the risk of atrial fibrillation than the general or abdominal obesity. According to some studies, epicardial fat around the left atrium is a strong predictor of the development at atrial fibrillation. Also, the amount of the fat is associated with the effectiveness of cardioversion and the risk of developing thromboembolic stroke in patients with atrial fibrillation. The number of such works is small, since tomographic examinations are not needed if intra-atrial thrombosis is suspected, and transthoracic echocardiograthy does not allow visualization of atrial fat. However, transesophageal echocardiography is widely used in patients with atrial fibrillation and allows to measure the structures that serve as depots of epicardial fat, namely the interatrial septum and left lateral ridge. Accumulation of epicardial fat leads to thickening of these structures. This can be used to study the relationship between epicardial obesity and the risk of thromboembolic complications in patients with atrial fibrillations.

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