Myocardial deformation and twist mechanics in adults with metabolic syndrome: Impact of cumulative metabolic burden

Abstract

Objective: The aim of the study is to characterize left ventricular (LV) myocardial mechanics in adults with metabolic syndrome (MetS), and elucidate the effects of multiple risk-factors on myocardial function using speckle tracking echocardiography (STE); a more sensitive method than conventional echocardiography for detecting subclinical myocardial dysfunction. Design and Methods: Cross-sectional analyses of 92 adults (50-70 years) with MetS, and 50 healthy controls included conventional echocardiography, blood biochemistry, and STE-derived myocardial longitudinal, circumferential, and twist mechanics. Results: Using conventional measures, MetS participants revealed LV hypertrophy and reduced diastolic function compared with controls, while systolic function was preserved. From STE, MetS participants showed attenuated longitudinal strain (216.8% 6 2.8% vs. 220.6% 6 2.7%), and both diastolic (1.1 6 0.2 vs. 1.4 6 0.3 s s 21 ) and systolic (21.0 6 0.1 vs. 21.2 6 0.2 s s 21 ) strain rate (SR). Circumferential strain, SR, and twist mechanics did not differ. Participants with the highest number of MetS factors or diabetes demonstrated the greatest reduction in longitudinal strain and SR. Abdominal obesity, TNF-a, HbA 1c , and systolic dyssynchrony explained 48% of impairment in longitudinal strain. Conclusions: Impaired longitudinal myocardial diastolic and systolic function, but preserved circumferential function and twist mechanics were found in MetS participants, indicative of altered subendocardial function. This dysfunction was best predicted by abdominal obesity, inflammation, glucose-intolerance, and systolic dyssynchrony.

Fragmented QRS complexes are associated with left ventricular systolic and diastolic dysfunctions in patients with metabolic syndrome

“…Our control group's fQRS percentage can be expected to be higher than that of the healthy population. Metabolic syndrome is known to be associated with deterioration in LV systolic and diastolic functions [3][4][5]. Consistent with previous studies, in our study, MetS patients had diastolic dysfunction detected by lower E velocity and E' velocity and higher A velocity, A' velocity, E/E' ratio than the non-MetS controls.…”

“…MetS is associated with a 5-fold increase in the risk of type 2 diabetes mellitus and 2-fold risk of developing cardiovascular disease over the next 5 to 10 years [17]. MetS is known to be associated with deterioration in LV systolic and diastolic functions [3][4][5]. Myocardial fibrosis is thought to be one of the contributors to this deterioration [6,7,18].…”

“…MetS is diagnosed when three or more of these metabolic abnormalities are present in the same person, according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) [2]. MetS has been shown to be associated with left ventricular (LV) systolic and diastolic dysfunctions [3][4][5]. The mechanism behind cardiac impairment in MetS is multifactorial, but one of the pivotal contributors is thought to be myocardial fibrosis [6,7].…”

Impaired Mechanics of Left Ventriculo-Atrial Coupling in Patients With Diabetic Nephropathy

“…29 Additionally, it was reported that GLS in obese patients was significantly reduced in line with the degree of metabolic syndrome, especially in patients with central obesity. 30 Accordingly, our finding from the multivariate analysis as shown in Table 3 suggested that a reduction in GLS through obesity and progression of diabetic nephropathy led to loss of LAS-a, while aging played a role in LA compensatory regulation.…”

Comparative Analysis of the Efficacy of Fixed-Dose Combinations of Amlodipine/Lisinopril and Bisoprolol/Hydrochlorthiazide in Patients With Essential Arterial Hypertension Combined With Obesity and Overweight

“…Crendal E. с соавт. [14] по-казали, что у лиц с метаболическим синдромом цент-ральное ожирение служит достоверным предиктором снижения ГПС ЛЖ. Большую жесткость миокарда ЛЖ в подгруппе пациентов с ГБ с ожирением по сравнению с пациентами без ожирения в нашем исследовании можно объяснить различными механизмами.…”