Assessment of left ventricular geometry, functions and mass in patients with metabolic syndrome

Abstract

Background and aims The frequent coexistence of obesity, arterial hypertension, and lipid and carbohydrate disorders is well known. Although these conditions have been identified as independent risk factors for impaired left ventricular diastolic function, there is a paucity of data on the dysfunction among patients with metabolic syndrome (MS). The aim of this study was to determine the impact of metabolic syndrome on left ventricular systolic and diastolic functions, mass and geometry by using conventional echocardiography and pulsed wave tissue Doppler imaging in individuals with MS compared to healthy subjects. Methods The study included 120 subjects divided by half into control and case group: 60 subjects (30 males and 20 females) with MS (diagnosed according to consensus statement from the International Diabetes Federation (platinum standard)) aged 54.4 ± 9.5 years and 60 healthy subjects (32 males and 28 females) aged 50.3 ± 13.7 years. Left ventricular ejection fraction (LVEF) was measured with the Tiech method in the short axis parasternal view by averaging measurements from five consecutive cardiac cycles. The LV diastolic function was estimated with Doppler measurement of transmitral blood flow and determination of the maximal rates for E and A peaks, E/A ratio, delay time (DT) for early diastolic filling rate, E′, A′ and E′/A′ ratio according to criteria of the European Study Group on diastolic heart failure. IMP was be calculated as the sum of IVRT and IVCT divided by ventricular ET (IMP = IVRT + IVCT/ET). LV mass was determined using the corrected cube formula as (0.80 × {1.04 × [(septal thickness + LV internal diameter + posterior wall thickness) 3 − (LV internal diameter) 3 ]} + 0.6). Results The assessed parameters using conventional and tissue Doppler echocardiography showing that those with metabolic syndrome had greater LV mass and significantly lower E/A ratio; increased LVH and significantly higher IMP, indicating impaired global left ventricular functions in patients with MS compared with control subjects without MS. There were no statistically significant difference in EF percentage. Conclusions Our results demonstrate that LV functions are impaired in patients with metabolic syndrome using IMP and E/A ratio. LVH incidence are higher in metabolic syndrome patients. To conclude metabolic syndrome are associated with significant cardiac functions deterioration and should be prevented and treated in proper manner.