Background Metabolic syndrome (MetS) and visceral obesity represent important cardiometabolic risk factors. Right ventricular (RV) function is affected in MetS. Epicardial adipose tissue is a metabolically active organ which might influence cardiac morphology and function, especially in patients with MetS. Epicardial fat thickness (EFT) is proposed as a new marker of visceral obesity. Purpose The objective of our study was to evaluate the role of EFT and RV hypertrophy in global (determined by Tei index) and diastolic function of RV in patients with MetS. Methods The study included 85 subjects with MetS (mean age 52±9.1 years) and 85 controls without MetS (mean age 50±8.9 years, P=0.06). MetS was defined by ≥3 criteria of International Diabetes Federation and American Heart Association/National Heart, Lung, and Blood Institute. All the subjects underwent complete 2D echocardiography with the assessment of the ratio of early and late diastolic tricuspid flow velocities (Et/At), the ratio of early diastolic tricuspid flow velocity and early diastolic tricuspid annular velocity (Et/e't), Et deceleration time (DT), RV end-diastolic free wall thickness (EDWT) and EFT. We determined Tei index of RV by pulsed and pulsed tissue Doppler. Results All the parameters of RV diastolic function, as well as Tei index, were significantly changed in MetS group: Et/At 0.85±0.39 vs. 1.17±0.43, P<0.001; Et/e't 5.1±1.3 vs. 4.5±0.8, P<0.001; DT 235±8 ms vs. 208±14 ms, P<0.001; Tei index by pulsed Doppler (0.48±0.05 vs. 0.34±0.06, P<0.001) and by pulsed tissue Doppler (0.58±0.05 vs. 0.46±0.04, P<0.001). Also, RV EDWT was significantly higher in MetS patients (6.3±0.8 mm vs. 4.6±1.2 mm, P<0.001) and positively correlated with Tei index (r=0.658, P<0.001; fig.1.A), Et/e't (r=0.269, P<0.001) and EFT (r=0.547, P<0.001). EFT was higher in MetS subjects (7.9±0.07 mm vs. 5.4±1.2 mm, P<0.001) and correlated with RV Tei index (r=0.614, P<0.001; fig.1.B), Et/e't (r=0.432, P<0.001). Multivariate regression analysis showed that systolic blood pressure, plasma glucose level, EFT and RV EDWT were independently associated with RV global and diastolic dysfunction in patients with MetS (P<0.05 for all parameters). Conclusions Our findings support that MetS is associated with diastolic and global dysfunction of RV. In subjects with MetS increased EFT and RV hypertrophy are independently associated with RV diastolic and global function. Funding Acknowledgement Type of funding source: None
Background: Pulmonary arterial hypertension (PAH) involves many different clinical conditions and has an important impact on the right ventricular (RV) function and patients prognosis. Some of these conditions can be potentially curable, for example, congenital heart disease that could be surgically repaired. Case Presentation: We present a case of 41-year-old woman with a progressive shortness of breath, without evident explication. First, she was suspected to have chronic thromboembolic PAH, which was not confirmed by clinical and imaging data. Even arrhythmogenic RV cardiomyopathy was suspected according to the data obtained from the first cardiac magnetic resonance (CMR) imaging. However, due to a step-up in oxygen saturation during the right heart catheterization (RHC), the presence of rare congenital heart disease, such as partial anomalous of pulmonary venous return (PAPVR), was suspected and then confirmed by the repeated CMR. Conclusions: PAPVR is a rare congenital heart disease that could be suspected during the RHC and represents a potentially curable cause of PAH.
Obesity is noted to be an independent cardiovascular disease (CV) risk factors, which is demonstrated by epidemiological studies. This is why, anthropometric measurements are frequently used to highlight general and visceral obesity. Various anthropometric indicators related to obesity are known, which aim to predict the metabolic risk factors involved in the development of CVD: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waisttoheight ratio (WHtR). Many studies have postulated that, depending on population, sex, age and ethnic group, the predictive power of different anthropometric indices may vary, and their systematic evaluation would be useful in risk stratification of patients with CV pathologies.
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