Metabolic Syndrome Impacts the Right Ventricle: True or False?

Abstract

The impact of metabolic syndrome (MS) on the right ventricle (RV) is not clarified. The aim of this study was to evaluate the influence of MS and its components on RV structure and function. The study included 265 subjects with MS and 118 controls adjusted by age. MS was defined by the presence of ≥3 ATP-NCEP III criteria. All subjects underwent laboratory blood tests, complete two-dimensional, pulse, and tissue Doppler echocardiography. We determined the ratio of early and late diastolic tricuspid flow velocities (E/A)(t), and the ratio of early diastolic transtricuspid and septal tricuspid annuli flow velocity (E/e')(t). RV Tei index represents the sum of tricuspid isovolumic relaxation time (IVRT) and tricuspid isovolumic contraction time (IVCT) divided by RV ejection time (ET) [(IVRT + IVCT)/ET]. Multiple regression analysis showed that systolic blood pressure (β = 0.104, P = 0.021), waist circumference (β = 0.093, P = 0.033), glucose level (β = 0.087, P = 0.045), left ventricular mass (LVmass) index (β = 0.218, P < 0.001) and relative LV wall thickness (β = 0.144, P = 0.034) were independently associated with the RV hypertrophy. Multivariate analysis showed that waist circumference (β = 0.152, P = 0.013), glucose level (β = 0.119, P = 0.039), LVmass index (β = 0.267, P < 0.001), the relative LV wall thickness (β = 0.184, P = 0.005), RV wall thickness (β = 0.175, P = 0.008), and (E/e')m (β = 0.143, P = 0.025) were independently associated with (E/e')(t). Similar results were obtained for RV Tei index. MS has an important role in damage of RV structure and function. Among MS criteria systolic blood pressure, waist circumference and glucose level were independently associated with RV structure and function.