RELATIONSHIP BETWEEN METABOLIC SYNDROME AND LEFT VENTRICULAR REMODELING: INFLUENCE OF GENDER: PP.22.356

Abstract

Objective: Conflicting data are available about a possible influence of gender on the relationship between metabolic syndrome (MetS) and left ventricular (LV) remodeling. This case-control study was aimed to evaluate if the impact of MetS on LV mass and function is different between men and women. Design and Methods: We enrolled 200 subjects without diabetes or overt cardiovascular diseases, never treated with antihypertensive drugs or statins: 60 men (M+) and 40 women (W+) with MetS (AHA 2005 criteria), 60 men (M-) and 40 women (W-) without MetS. Each subject without MetS was matched with one with MetS by age, gender and 24 hour systolic and diastolic blood pressure. The patients underwent blood tests, 24-hour BP monitoring, echocardiographic examination. Results: Fasting glycemia and triglycerides were higher and HDL cholesterol lower in M+ and W+ groups. LV diastolic diameter and LV ejection fraction were normal in all and similar between subjects with and without MetS. Septal and posterior wall thickness were significantly higher in W+ than in W-; only septal thickness was higher in M+ than in M-. Relative wall thickness was higher in W+ than in W- (0.43 ± 0.07 vs 0.39 ± 0.05, p = 0.004), similar between M+ and M- (0.41 ± 0.06 vs ± 0.41 ± 0.07, ns). LV mass indexed to height to the power of 2.7 was significantly higher in M+ and F+ than in M- and F-; prevalence of LV hypertrophy (LV mass index > 44 g/m2.7 women, > 48 g/m2.7 men) was higher in W+ than W- (80% vs 52.5%, p = 0.018), not significantly different between M+ and M- (58.3% vs 41.7%, ns). Mean values of LV diastolic parameters were similar between M+ and M-, whereas E/A ratio (transmitral Doppler flow) and Em/Am (Tissue Doppler Imaging) were significantly (p = 0.01) lower in W+ than W−. Conclusions: The impact of MetS on LV remodeling is influenced by gender: the effects of MetS are more pronounced in women, with the development of LV concentric hypertrophy and diastolic dysfunction.