Measurement Of Epicardial Adipose Tissue Volume And COVID-19 Based On CT Correlation Study

Purpose:Novel coronavirus pneumonia was measured by chest CT and the correlation between the serum COVID-19 and the epicardial adipose tissue volume was analyzed.The relationship between epicardial adipose tissue volume and new crown pneumonia was explored,and the risk factors for clinical deterioration were explored.Method:This is an observational study（case-control study）,which has been approved by the ethics committee and approved the exemption of informed consent.This part of the study continuously enrolled 89 patients diagnosed as covid-19 in Tonghua Hospital of Jilin Province from January 18,2021 to March 7,2021.According to whether they entered ICU,used endotracheal intubation or died,they were divided into two groups: 27 patients in the clinical deterioration group and62 patients in the control group.1、Collect the basic information of all patients related to the study（including age and gender）,as well as the clinical information at the time of diagnosis（including serological indexes and chest CT images）.2、The epicardial fat volume and lung lesion volume were measured by 3D slicer software based on chest CT images.Result:1、In the clinical deterioration group,interleukin-2,interleukin-4 and tumor necrosis factor-α、 Interference-γ、There was no significant difference in the level of high-sensitivity troponin-I between the two groups（P > 0.05）.The levels of age,interleukin-6,interleukin-10,C-reactive protein,lactate dehydrogenase,D-dimer,pro brain natriuretic peptide,myoglobin,procalcitonin,creatine kinase and epicardial adipose tissue volume in the control group were significantly higher than those in the control group（P < 0.05）.2、The volume of pneumonia lesion,total burden of pneumonia and epicardial adipose tissue in the clinical deterioration group were significantly higher than those in the control group.The difference between the two groups was statistically significant（P < 0.01）.3、Epicardial adipose tissue volume: epicardial adipose tissue volume was positively correlated with inflammatory indexes interleukin-6,C-reactive protein,lactate dehydrogenase,D-dimer,pro brain natriuretic peptide,myoglobin and procalcitonin in the two groups,and the correlation coefficients were 0.382,0.537,0.473,0.235,0.398,0.391 and 0.353 respectively;There was a significant positive correlation with the total burden of pneumonia,and the correlation coefficient was 0.754.4、Lung lesion volume: the lung lesion volume of the two groups was positively correlated with inflammatory indexes interleukin-6,interleukin-10,C-reactive protein,lactate dehydrogenase,D-dimer,pro brain natriuretic peptide,myoglobin and procalcitonin,and the correlation coefficients were 0.565,0.338,0.295,0.395,0.456 and 0.328 respectively.5、Myocardial injury related markers: myocardial injury related markers include lactate dehydrogenase,creatine kinase,creatine kinase MB type,brain natriuretic peptide precursor,high-sensitivity troponin-I,myoglobin and procalcitonin.In the two correlation analyses,interleukin-6 and creatine kinase MB type,brain natriuretic peptide precursor,myoglobin Procalcitonin was slightly positively correlated（R values were 0.256,0.486,0.396,0.275,P < 0.05）,moderately positively correlated with lactate dehydrogenase（R values were 0.533,P < 0.01）,and not significantly correlated with creatine kinase and high-sensitivity troponin-i.C-reactive protein was slightly positively correlated with myoglobin,pro brain natriuretic peptide and procalcitonin（R values were0.365,0.449 and 0.301,respectively,P < 0.01）;it was moderately positively correlated with lactate dehydrogenase（r value was 0.601,P < 0.01）;it was not significantly correlated with creatine kinase,creatine kinase MB type and high-sensitivity troponin-i.D-dimer was slightly positively correlated with myoglobin and procalcitonin（R values were0.397 and 0.288,respectively,P < 0.01）;moderate positive correlation with lactate dehydrogenase and pro brain natriuretic peptide（R values were 0.569 and 0.573,respectively,P < 0.01）;no significant correlation with creatine kinase,creatine kinase MB type and hypersensitive troponin-i.interleukin-10 was slightly positive correlation with lactate dehydrogenase and pro brain natriuretic peptide（R values were 0.367 and 0.361,respectively,P < 0.01）,There was a uniform and significant correlation with other markers.Tumor necrosis factor-α There was no uniform and significant correlation with other standards except that it was slightly positively correlated with pro brain natriuretic peptide（r value was 0.269,P < 0.01）-γ There was no significant correlation with these markers of myocardial injury.6、Novel coronavirus pneumonia: independent risk factors for clinical deterioration: multivariate risk regression Analysis showed that interleukin-6（β = 0.052,95% CI:1.000-1.108,P value 0.049）;Lactate dehydrogenase（β= 0.21,95% CI: 1.007-1.036,P value 0.004）;Epicardial adipose tissue volume（β= 0.34,95% CI: 1.006-1.064,P value 0.0 017）.7、ROC curve: the area under the interleukin-6 curve（AUC）,specificity and sensitivity were 0.831（95% CI: 0.733-0.928）,0.823 and 0.741 respectively;the area under the lactate dehydrogenase curve（AUC）,specificity and sensitivity were0.934（95% CI: 0.880-0.988）,0.887 and 0.852 respectively;the area under the epicardial adipose tissue volume curve（AUC）,specificity and sensitivity were 0.867 respectively（95%CI:0.791-0.942）、0.79、0.815.Conclusion:CT based measurement of epicardial adipose tissue volume,interleukin-6 and lactate dehydrogenase are independent risk factors for clinical deterioration of New Coronavirus pneumonia.