Subclinical systolic and diastolic dysfunctions in patients with metabolic syndrome and angiographically normal coronary arteries: An echocardiographic study

Samiei, Niloufar; Bayat, Maryam; Firouzi, Ata; Dehghani-Tafti, Faezeh; Parsaee, Mozhgan; Rahimi, Shahin; Ahmadi, Somayyeh; Pourmojib, Maryam; Ghaemmaghami, Zahra; Rezaei, Yousef; Peighambari, Mohammad Mehdi

doi:10.1002/jcu.22568

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…In the MetS group, BMI and waist circumference were significantly higher than the healthy subjects. This is in line with the data from Samiei et al, who concluded significantly greater BMI and waist circumferences amongst participants with MetS [23].…”

Section: Discussionsupporting

confidence: 92%

Assessment of Right Ventricular Function by Speckle Tracking Echocardiography in Patients with Metabolic Syndrome

Ibrahim¹,

Shokr²,

Al-Sawasany³

2021

CCR

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Metabolic syndrome (MetS) and visceral adiposity are crucial cardio metabolic risk factors. There is evidence of subclinical left ventricular myocardial dysfunction in individuals with metabolic syndrome (MetS). However, the effect of MetS on the right ventricle (RV) is yet unknown. By using 2D Speckle Tracking Echocardiography, we investigated the link between MetS and right ventricle function. This study was conducted on 50 MetS patients and 25 age and gender matched individuals (control group). The MetS is diagnosed when presence of ≥3 American Heart Association/National Heart, Lung, and Blood Institute criteria. All individuals had sufficient laboratory assays as well as a thorough 2D examination including tissue Doppler imaging (TDI) and R. V global longitudinal strain (GLS) during the period between November 2019 and December 2020. The metabolic group had a statistically significant lower RV-GLS (-18.27±2.16 in MetS subjects vs. -26.64±3.05 in control subjects, P<0.001), a significantly lower E/A ratio (0.95±0.12 in MetS subjects vs. 1.14±0.15 in controls, P<0.001), and a statistically significant increase in the E/Em ratio (5.66±1.03 in MetS subjects vs. 4.24±0.46 in controls, P<0.001). Other echocardiographic or functional capacity tests revealed no significant differences between the two groups. We concluded that MetS was associated with preclinical right ventricle systolic dysfunction detected by 2D-STE observed with Normal RV by TAPSE and FAC and Normal left ventricular ejection fraction (LVEF) in addition to RV diastolic dysfunction.

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Section: Discussionsupporting

confidence: 92%

Assessment of Right Ventricular Function by Speckle Tracking Echocardiography in Patients with Metabolic Syndrome

Ibrahim¹,

Shokr²,

Al-Sawasany³

2021

CCR

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“…In addition to the prognostic value of fQRS in patients with cardiovascular diseases, it has also been found to be associated with subclinical myocardial dysfunction in patients with coronary artery disease, diabetes mellitus, and chronic kidney disease . The assessment of myocardial tissue by conventional echocardiography is load‐ and angle‐dependent, but 2‐dimensional speckle‐tracking echocardiography (2D‐STE) lacks such a limitation for the evaluation of myocardial mechanics . Although left ventricular ejection fraction (LVEF) is commonly used for the evaluation of LV function, 2D‐STE parameters, mainly global longitudinal strain (GLS), have been found to be a feasible modality for examination of left ventricle (LV) function …”

Section: Introductionmentioning

confidence: 99%

“…19 The assessment of myocardial tissue by conventional echocardiography is load-and angle-dependent, but 2-dimensional speckle-tracking echocardiography (2D-STE) lacks such a limitation for the evaluation of myocardial mechanics. [20][21][22][23] Although left ventricular ejection fraction (LVEF) is commonly used for the evaluation of LV function, 2D-STE parameters, mainly global longitudinal strain (GLS), have been found to be a feasible modality for examination of left ventricle (LV) function. 24 In this case-control study, we sought to determine the relationship between the presence of fQRS in apparently healthy individuals without cardiovascular diseases and preserved LVEF and subclinical LV dysfunction using 2-dimensional transthoracic echocardiography (2D-TTE) with the implementation of tissue Doppler imaging (TDI) and speckle-tracking echocardiography.…”

Section: Introductionmentioning

confidence: 99%

Fragmented QRS and subclinical left ventricular dysfunction in individuals with preserved ejection fraction: A speckle‐tracking echocardiographic study

Dehghani

Rostamzadeh

Abbasnezhad

et al. 2019

Journal of Arrhythmia

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Introduction Fragmented QRS (fQRS) complex on routine 12‐lead electrocardiogram (ECG) predicts adverse outcomes in patients with cardiovascular diseases. In addition, it has been found to be associated with subclinical myocardial dysfunction in chronic diseases. We sought to investigate the relationship between the presence of fQRS with the myocardial functions in individuals free from known systemic cardiovascular diseases. Methods In a case‐control study, we evaluated normal individuals from March 2017 to February 2018. All participants underwent a 2‐dimensional transthoracic echocardiographic examination using tissue Doppler imaging (TDI) and speckle‐tracking echocardiography. In addition, all participants were examined using a 12‐lead surface ECG, and patients with fQRS and a group of age‐ and sex‐matched controls without fQRS were enrolled in our study. Results The patients' mean age was 40.3 ± 10.7 and 35.4 ± 11.2 years in fQRS‐positive and fQRS‐negative groups, respectively (P = .110). Patients with fQRS had significantly lower values of apical left ventricular global longitudinal strain (LV GLS) in 2‐chamber (16.9 ± 2.5 vs. 20.5 ± 3.3, P < .001), 4‐chamber (16.9 ± 3.4 vs. 20.1 ± 3, P = .001), LAX views (17.7 ± 2.8 vs. 20.8 ± 3.5, P = .001), and averaged LV GLS (17 ± 2.6 vs. 20.4 ± 2.7, P < .001) values compared to patients without fQRS. In a multivariate analysis, averaged LV GLS and smoking history were independent predictors for positive fQRS. Conclusion The presence of fQRS on 12‐lead ECG in healthy population was associated with lower values of LV GLS compared to normal individuals without fQRS.

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“…In a previous study, clinical and subclinical systolic and diastolic dysfunction have been demonstrated by echocardiography in MS patients without coronary artery disease ( 4 , 5 ). Furthermore, LV diastolic dysfunction, instead of systolic dysfunction, has been associated with limited exercise capacity independent of ischemia ( 6 ).…”

Section: Introductionmentioning

confidence: 93%

Cardiac function and exercise capacity in patients with metabolic syndrome: A cross-sectional study

Chen

Wang²,

Dong³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundMetabolic syndrome is a pre-diabetes condition that is associated with increased cardiovascular morbidity and mortality. We aimed to explore how exercise capacity, cardiac structure, and function were affected in patients with metabolic syndrome.MethodsOutpatients with echocardiography and exercise stress test combined with impedance cardiography (ETT + ICGG) results available from Nov 2018 to Oct 2020 were retrospectively enrolled. Echocardiographic, ETT + ICG profiles, and exercise performance were compared between patients with metabolic syndrome and the ones without. Sensitivity analyses were performed excluding patients without established coronary heart disease and further 1:1 paired for age and gender, respectively. Multiple linear regression was used to find out related predictors for maximal metabolic equivalents (METs).ResultsThree hundred and twenty-third patients were included, among whom 97 were diagnosed as metabolic syndrome. Compared to patients without metabolic syndrome, echocardiography showed that patients with metabolic syndrome had a significantly lower E/A ratio (p < 0.001). Besides, they have larger left atrium, larger right ventricle, and thicker interventricular septum (all p < 0.001), but similar left ventricular ejection fraction (P = 0.443). ICG showed that patients with metabolic syndrome had significantly higher stroke volume at rest and maximum (p < 0.001), higher left cardiac work index at rest and maximum (p = 0.005), higher systemic vascular resistance (SVR) at rest (p < 0.001), but similar SVI (p = 0.888). During exercise, patients with metabolic syndrome had lower maximal METs (p < 0.001), and a higher proportion suffering from ST-segment depression during exercise (p = 0.009). Sensitivity analyses yielded similar results. As for the linear regression model, 6 independent variables (systolic blood pressure, BMI, E/A ratio, the height of O wave, the peak value of LCWi, and the baseline of SVR) had statistically significant effects on the maximal METs tested in exercise (R = 0.525, R2 = 0.246, P < 0.001).ConclusionPatients with metabolic syndrome had significant structural alteration, apparent overburden of left ventricular work index, pre-and afterload, which may be the main cause of impaired exercise tolerance.

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Subclinical systolic and diastolic dysfunctions in patients with metabolic syndrome and angiographically normal coronary arteries: An echocardiographic study

Abstract: In MetS without coronary artery disease, echocardiography demonstrated subclinical systolic and diastolic dysfunction.

Cited by 7 publications

References 21 publications

Assessment of Right Ventricular Function by Speckle Tracking Echocardiography in Patients with Metabolic Syndrome

Assessment of Right Ventricular Function by Speckle Tracking Echocardiography in Patients with Metabolic Syndrome

Fragmented QRS and subclinical left ventricular dysfunction in individuals with preserved ejection fraction: A speckle‐tracking echocardiographic study

Cardiac function and exercise capacity in patients with metabolic syndrome: A cross-sectional study

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