Association of metabolic syndrome and electrocardiographic markers of subclinical cardiovascular disease

Abstract

BackgroundThe metabolic syndrome (MetS) and its components are well-established risk factors for cardiovascular diseases (CVD). It is inconclusive whether MetS and MetS score are associated with electrocardiographic markers of subclinical CVD, therefore we investigated this in a population without pre-existing CVD.MethodsWe performed a cross-sectional analysis in the Netherlands Epidemiology of Obesity study, a population-based cohort including 6671 participants aged 45–65. We excluded participants with pre-existing CVD (n = 499) or missing MetS components (n = 58). MetS was defined based on a modified definition of Adult Treatment Panel III. Subclinical CVD parameters were determined with 12-lead ECGs. MetS score was defined as number of abnormal MetS components and obesity as Body Mass Index (BMI) ≥30 kg/m2. We performed weighted adjusted linear regression analyses.ResultsOur study population (n = 6114) had a mean (SD) BMI of 26.3 (4.4) kg/m2 and MetS was present in 24% of participants. All ECG parameters differed between participants with and without MetS. Per additional MetS component, heart rate was 0.17 SD (95% CI 0.15, 0.19) higher, P wave duration, QRS complex duration and corrected QT interval were longer [0.07 SD (0.05, 0.10), 0.04 SD (0.01, 0.06) and 0.05 SD (0.02, 0.08) respectively], P wave axis, T wave axis and QRS axis were lower [−0.10 SD (−0.12, −0.07), −0.07 SD (−0.10, −0.05) and −0.19 SD (−0.22, −0.16)] and percentage small Q-waves also increased per additional MetS component. Associations were stronger in non-obese than obese participants. In joint modelling of all MetS components, increased waist circumference showed strongest associations with ECG parameters.ConclusionsMetabolic syndrome score and its individual components, in particular abdominal obesity, are associated with ECG markers of subclinical CVD, showing the importance of limiting the amount of MetS components in both obese and non-obese persons.Electronic supplementary materialThe online version of this article (doi:10.1186/s13098-017-0238-9) contains supplementary material, which is available to authorized users.

The association of metabolic syndrome and QRS|T angle in US adults (NHANES III)

“…The current study confirms the results of the previous studies that concluded that MetS increases the risk for cardiac arrhythmias (Elffers et al, 2017;Faramawi, Sall, et al, 2008;Faramawi, Wildman, et al, 2008). However, herein we used a superior ECG parameter, that is, spatial QRS|T angle, to conventional ECG parameters that are associated with cardiac arrhythmias such as the T-wave deviation and QT interval (Elffers et al, 2017;Faramawi, Sall, et al, 2008;Faramawi, Wildman, et al, 2008). When we adjusted for other ECG parameters: PR interval, corrected QT interval, QRS interval, and QRS amplitude, MetS remained associated with abnormal QRS|T angle.…”

“…Those who met criteria for MetS are at a higher risk of cardiovascular morbidity and mortality (Mccullough, 2011;Mottillo et al, 2010). The presence of MetS has been associated with several ECG markers of cardiovascular disease (e.g., QRS complex duration, QT interval, T-wave axis) in a population-based cohort (Elffers et al, 2017). Using data obtained from NHANES III, Faramawi, Sall, and Kareem (2008) determined the presence of MetS was associated with ECG markers of cardiovascular disease: T-wave axis deviation and QT interval.…”

<p>The Association of Metabolic Syndrome and Its Components with Electrocardiogram Parameters and Abnormalities Among an Iranian Rural Population: The Fasa PERSIAN Cohort Study</p>

“…21 Surprisingly PR interval in our study was not at a significant relationship with metabolic syndrome. A cross-sectional analysis in the Netherlands 23 reported the mean of P and QRS axis 44.2 and 23.0 respectively in non-obese subjects which were near our results. Also, the same as our results, they observed a negative significant relationship between P and QRS axis with metabolic syndrome.…”

“…It is worth noting that some of these studies produced different results, indicating that although a few relevant studies exist in the world, this relationship continues to remain unknown. 14,23 Besides, knowing the effects of MetS and its components on ECG can be helpful for CVD risk prediction, and used by health authorities and decision-makers to change its epidemic spread in Iran. 24…”

Analysis of the determining factors of detectable P‐wave and amplitude of QRS complex sensed by implantable loop recorder

“…LA diameter is longer in higher BMI group and males 15 . QRS axis and P axis angle are greater in patients with lower BMI and metabolic syndrome 16,17 . Heart axis is greater in patients with lower BMI and younger age 18 .…”