Subclinical Myocardial Dysfunction in Metabolic Syndrome Patients without Hypertension

Abstract

BackgroundThe aim of this study was to evaluate myocardial function in patients with non-hypertensive metabolic syndrome.MethodsWe selected metabolic syndrome patients (n = 42) without evidence of hypertension and compared them to age-matched control individuals (n = 20). All patients were evaluated by two-dimensional and tissue Doppler echocardiography including tissue Doppler derived strain and strain rate measurements.ResultsThere were no significant differences between the two groups in mitral E and A inflow velocities or the E/A ratio. However, systolic and early diastolic myocardial velocities, and strain rate were significantly lower in patients with metabolic syndrome than in the control group (all p < 0.05). Multiple stepwise regression analyses revealed that age, waist circumference, and systolic blood pressure were independently associated with peak systolic myocardial velocity.ConclusionThese results indicate that metabolic syndrome patients without hypertension may have decrease of myocardial systolic and early diastolic velocities on tissue Doppler imaging, even if they appear to have normal systolic and diastolic function on conventional echocardiography.

Nonalcoholic fatty liver disease and vascular risk

“…The presence of abnormal cardiac geometry and function is well documented in MetS patients, in part related to insulin resistance, with diastolic dysfunction a common feature [43,44]. Similarly, NAFLD patients have also been shown to have diastolic function impairment compared with controls, independently of age, BMI and systolic blood pressure [45], and this finding appears to be linked to the amount of liver fat present [46].…”

Metabolically healthy and unhealthy obesity: differential effects on myocardial function according to metabolic syndrome, rather than obesity

“…Measurement of strain and strain rate detect pre-clinical myocardial abnormalities, which can help predict risk of cardiovascular events and mortality 21 . In patients with metabolic syndrome, subclinical left ventricular (LV) dysfunction has been detected (lower early diastolic and systolic tissue velocities accompanied by reduced strain and strain rates) compared to matched controls, worse in those with a greater number of components of the metabolic syndrome 22,23 .…”

“…skeletal muscle, liver and cardiac muscle), and therefore whether obesity is 91 metabolically healthy or unhealthy 37, 38 . However, there is currently no consensus on how to 92 define metabolic health or metabolically healthy obesity except for the inclusion of obesity 93 dysfunction in patients with an increased metabolic burden compared to control groups 22,23 . 102…”

Is left ventricular diastolic dysfunction independent from presence of hypertension in metabolic syndrome? An echocardiographic study

“…In all of these studies, it is stated that there is still debate on whether obesity or hypertension causes LVDD and this issue remains to be elucidated [28]. In a study conducted by Seo et al, diastolic function parameters in 42 MetS patients without hypertension were examined by echocardiographic methods and compared to the control group (n = 20), a decrease in myocardial systolic and early diastolic flow velocities was observed [29]. However, in this study, the patient group was compared to a control group of only 20 individuals, but no comparison was done with the hypertensive MetS group.…”