Preclinical Alterations in Myocardial Microstructure in People with Metabolic Syndrome

Abstract

Objective Metabolic syndrome (MetS) can lead to myocardial fibrosis, diastolic dysfunction and eventual heart failure. We evaluated alterations in myocardial microstructure in people with MetS using a novel algorithm to characterize ultrasonic signal intensity variation. Methods Among 254 participants without existing cardiovascular disease (mean age 42 ± 11 years, 75% women), there were 162 with MetS, 47 with obesity without MetS, and 45 non-obese controls. Standard echocardiography was performed, and a novel validated computational algorithm was used to investigate myocardial microstructure based on sonographic signal intensity and distribution. We examined the signal intensity coefficient (SIC, left ventricular microstructure). Results The SIC was significantly higher in people with MetS compared with people with (P<0.001) and without obesity (P=0.04), even after adjustment for age, sex, body mass index, hypertension, diabetes mellitus and triglyceride to HDL cholesterol (TG/HDL) ratio (P<0.05 for all). Clinical correlates of SIC included TG concentrations (r=0.21, P=0.0007) and the TG/HDL ratio (r=0.2, P=0.001). Conclusions Our findings suggest that preclinical MetS and dyslipidemia in particular, are associated with altered myocardial signal intensity variation. Future studies are needed to determine whether the SIC may help detect subclinical disease in people with metabolic disease, with the ultimate goal of targeting preventive efforts.

Gene and Protein Expression Profile of Selected Molecular Targets Mediating Electrophysiological Function in Pgc-1α Deficient Murine Atria

“…The latter is the typical result of altered expression or properties in ion channels underlying electrophysiological activity, or fibrotic or cardiomyopathic change influencing cardiomyocyte or cardiac tissue structure. The latter structural changes have also been reported in experimental diabetes [ 6 ] and metabolic syndrome [ 7 ].…”

Atrial Transcriptional Profiles of Molecular Targets Mediating Electrophysiological Function in Aging and Pgc-1β Deficient Murine Hearts

“…This indicates abnormalities in one or more of the ordered processes of action potential (AP) initiation, recovery, excitation and propagation. These in turn would reflect altered ion channel function or expression or structural, fibrotic or cardiomyopathic change altering AP conduction, findings reported in experimental diabetes (Russo and Frangogiannis, 2016) and metabolic syndrome (Ho et al, 2017).…”

Cardiac Microstructural Abnormalities Identify Women at Risk of Incident Heart Failure

“…12 Quantitative tissue analysis was performed as previously described. [4][5][6][7] Briefly, transthoracic B-mode parasternal long axis views were selected at end diastole. Images were inspected for quality and ability to visualize the mid-to-basal inferiolateral myocardial/pericardial interface.…”

“…4,5 It has been utilized to identify preclinical changes in the myocardium of patients with hypertension, hypertrophic cardiomyopathy gene carriers, and obese patients. 4,6,7 We hypothesized that the SIC is able to identify preclinical changes in patients who subsequently develop incident heart failure in the Framingham Offspring Cohort. By identifying the risk of future heart failure in patients prior to clinical disease, we may be able to more effectively prevent heart failure.…”