Left Ventricular Structural and Functional Changes in the Metabolic Syndrome

Mahmud, Azra; Almuntaser, Ibrahim; Brown, Angie; King, Gerard; Crean, Peter; Feely, J.

doi:10.1111/j.1559-4572.2008.00043.x

Cited by 14 publications

(22 citation statements)

References 35 publications

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“…MPI, which is detected by TDI, reflects both systolic and diastolic dysfunction. As some previous clinical studies, the MPI was significantly higher in the MetS groups than control subjects in our study (6, 22, 24, 25). …”

Section: Discussionsupporting

confidence: 85%

The role of isovolumic acceleration in predicting subclinical right and left ventricular systolic dysfunction in patient with metabolic syndrome

Ertürk¹,

Oner²,

Kalkan³

et al. 2015

Anadolu Kardiyol Derg

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Objective:The aim of this study was to assess subclinical left (LV) and right ventricular (RV) dysfunction novel load-independent isovolumic myocardial acceleration (IVA) derived from tissue Doppler imaging (TDI) in patient with metabolic syndrome (MetS).Methods:This study had an observational case-control design. The study included 133 subjects which were divided into two groups: 75 patients with MetS and 58 controls without MetS. MetS was defined by the presence of ≥3 criteria according to ATP-NCEP III guidelines. All the subjects underwent laboratory blood tests and complete conventional echocardiography and TDI. Student’s t, Mann-Whitney U, Pearson’s, and multiple regression analysis were used for statistical analysis.Results:There were no significant difference between two groups in terms of traditional echocardiographic parameters. The diastolic and global functions of both ventricles were significantly impaired in MetS group. The TDI-derived IVA of the LV and the RV was significantly lower in patients with MetS (3.2±0.9 vs. 4.0±1.4, p<0.001 and 2.6±0.7 vs. 3.1±0.9, p=0.001, respectively). Whereas, TDI derived systolic velocity (Sa), and peak myocardial velocity during isovolumic contraction (IVV) of both ventricles were similar between the two groups. In the multiple regression analysis, waist circumference and diastolic blood pressure were found to be an independent determinant of IVA of LV (β=-.223, 95% CI=-.034 -.002, p=0.004) and RV (β=-.527, 95% CI=-.085 -.020, p=0.002) respectively.Conclusion:MetS affects global, diastolic, and systolic functions of two ventricles. This disruption lead to decreased function of heart was related with raised risk factors of MetS

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Section: Discussionsupporting

confidence: 85%

The role of isovolumic acceleration in predicting subclinical right and left ventricular systolic dysfunction in patient with metabolic syndrome

Ertürk¹,

Oner²,

Kalkan³

et al. 2015

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

show abstract

“…We cannot provide a definitive explanation for this fact. However, some studies have reported that obesity with metabolic syndrome can be associated with diastolic dysfunction and abnormalities in left ventricular relaxation (17,28,48), although the described abnormal diastolic function is not unanimously reported (52). Thus it is possible to hypothesize that impairment in ventricular diastolic function hampered the normal diastolic filling in subjects with OMS, and this fact in turn resulted in the impaired VFR response.…”

Section: Discussionmentioning

confidence: 91%

Differences in hemodynamic response to metaboreflex activation between obese patients with metabolic syndrome and healthy subjects with obese phenotype

Milia

Velluzzi

Roberto

et al. 2015

American Journal of Physiology-Heart and Circulatory Physiology

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Patients suffering from obesity and metabolic syndrome (OMS) manifest a dysregulation in hemodynamic response during exercise, with an exaggerated systemic vascular increase. However, it is not clear whether this is the consequence of metabolic syndrome per se or whether it is due to concomitant obesity. The aim of the present investigation was to discover whether OMS and noncomplicated obesity resulted in different hemodynamic responses during the metaboreflex. Twelve metabolically healthy but obese subjects (MHO; 7 women), 13 OMS patients (5 women), and 12 normal age-matched controls (CTL; 6 women) took part in this study. All participants underwent a postexercise muscle ischemia protocol to evaluate the metaboreflex activity. Central hemodynamics were evaluated by impedance cardiography. The main result shows an exaggerated increase in systemic vascular resistance from baseline during the metaboreflex in the OMS patients as compared with the other groups (481.6 ± 180.3, -0.52 ± 177.6, and -60.5 ± 58.6 dynes·s(-1)·cm(-5) for the OMS, the MHO, and the CTL groups, respectively; P < 0.05). Moreover, the MHO subjects and the CTL group showed an increase in cardiac output during the metaboreflex (288.7 ± 325.8 and 703.8 ± 276.2 ml/m increase with respect to baseline), whereas this parameter tended to decrease in the OMS group (-350 ± 236.5 ml/m). However, the blood pressure response, which tended to be higher in the OMS patients, was not statistically different between groups. The results of the present investigation suggest that OMS patients have an exaggerated vasoconstriction in response to metaboreflex activation and that this fact is not due to obesity per se

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“…The pulse pressure, pulse wave velocity and echocardiographic surrogate measurements of arterial stiffness increase with age and in certain disease states, indicating that they themselves are associated with increased cardiovascular risks, including that of hypertension, diabetes mellitus, hyperlipidemia, obesity and end-stage renal failure (17)(18)(19)(20). However, the state of arterial elasticity in subjects with prediabetes has also received little attention.…”

Section: Discussionmentioning

confidence: 99%

Relationship between Aortic Stiffness and the Left Ventricular Function in Patients with Prediabetes

et al. 2014

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Objective Several studies have shown that arterial stiffness and ventricular dysfunction are increased in individuals with type 2 diabetes. Aortic stiffness (AS) reflects the mechanical tension and elasticity of the aorta, and increased aortic stiffness is a risk factor for cardiovascular disease. The aim of this study was to evaluate the degree of aortic stiffness and its relationship with the left ventricular (LV) function in patients with prediabetes and healthy control subjects. Methods The study groups were composed of 50 patients with prediabetes and 47 healthy adults with similar demographic characteristics. The LV systolic and diastolic functions were assessed using standard two dimensional (2D) echocardiography, M-mode echocardiography, pulsed-wave (PW) echocardiography and tissue Doppler echocardiography. The degree of aortic strain and distensibility were calculated based on the aortic diameters measured on M-mode echocardiography at a level 3 cm above the aortic valve and the blood pressure values obtained on sphygmomanometry. Results There were significant differences between the prediabetic and control groups in the degree of aortic strain (4.7±2.8% vs. 14.9±4.5%; respectively, p<0.001) and distensibility (2.0±1.5 vs. 6.8±2.3; 10 -3 cm 2 dyn -1 , respectively, p<0.001). In addition, significant differences were observed between the patient and control groups in the parameters of the LV systolic and diastolic functions. The left atrial diameter was significantly larger in the prediabetics than in the controls (35.9±3.9 vs. 33.7±4.2; respectively, p=0.027). Conclusion AS is increased in patients with prediabetes. In addition, there is a significant relationship between the degree of aortic stiffness and the LV function in this patient population. Therefore, the aortic elasticity parameters calculated on 2D echocardiography are useful for predicting early cardiovascular risks in prediabetics.

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Left Ventricular Structural and Functional Changes in the Metabolic Syndrome

Cited by 14 publications

References 35 publications

The role of isovolumic acceleration in predicting subclinical right and left ventricular systolic dysfunction in patient with metabolic syndrome

The role of isovolumic acceleration in predicting subclinical right and left ventricular systolic dysfunction in patient with metabolic syndrome

Differences in hemodynamic response to metaboreflex activation between obese patients with metabolic syndrome and healthy subjects with obese phenotype

Relationship between Aortic Stiffness and the Left Ventricular Function in Patients with Prediabetes

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