Association of blunted heart rate recovery with epicardial fat volume in patients with metabolic syndrome

Abstract

Objective To evaluate the association between epicardial fat volume(EFV) and blunted heart rate recovery(HRR) in patients with metabolic syndrome(MS). Methods Screening subjects in epidemiologic study of metabolic syndrome in Oriental and Qinfeng Community in Taiyuan and health physical examination in Shanxi Province People's Hospital, which was conducted among 486 patients from July to September in 2011, one hundred and nine patients with MS and forty one healthy controls were included in the study. All subjects received a questionnaire survey and physical examination. Laboratory results included fasting blood glucose, glycosylated hemoglobin, triglyceride, cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, uria acid and fasting insulin were also collected. Coronary computed tomography angiography(CCTA) was performed to exclude obstructive disease(≥50% luminal narrowing). Then EFV and HRR at 1 min after exercise termination(HRR-1)were measured and compared between two groups. Results EFV((159±62) vs (182±50) cm3, t=6.91, P<0.05) was increased and HRR-1((21±8) vs (26±9) time/min, t=-5.74, P<0.05)was significantly reduced in patients with MS compared to those in control group.Among the MS patients, subjects with blunted HRR had increased EFV compared to patients without blunted HRR((197±56) vs (178±62) cm3,t=7.90, P<0.05). In multivariate analysis, EFV was the only independent predictor of blunted HRR in patients with MS(OR=2.46, P<0.05). Furthermore EFV of equel to or bigger than 163.4 cm3 was associated with the blunted HRR with 86.1% sensitivity and 57.3% specificity(ROC area under curve: 0.74). Conclusion EFV is an independent predictor of blunted HRR in patients with MS. Key words: Metabolic syndrome; Heart rate recovery; Epicardial adipose tissue