European Heart Journal Advance Access originally published online on February 20, 2007
European Heart Journal 2007 28(5):553-559; doi:10.1093/eurheartj/ehl526
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Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass
1 Cardiovascular Imaging and Clinical Research Core Laboratory, Campus Box 8086, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
2 Cardiovascular Division, Campus Box 8086, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
3 Cardiovascular Imaging Laboratory, Mallinckrodt Institute of Radiology, Campus Box 8067, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA
Received 14 September 2006; revised 8 December 2006; accepted 18 January 2007; online publish-ahead-of-print 20 February 2007.
* Corresponding author. Tel: +1 314 362 1076; fax: +314 747 8170. E-mail address: lfuentes{at}wustl.edu
Aim To characterize the extent to which metabolic syndrome criteria predict left ventricular (LV) structure and function.
Methods and results Metabolic syndrome criteria were assessed in 607 adults with normal LV function. The cohort was grouped according to the number of criteria satisfied: (1) Absent (0 criteria, n = 110); (2) Pre-Metabolic Syndrome (1–2 criteria, n = 311); and (3) Metabolic Syndrome (
3 criteria, n = 186). Echocardiography was used to assess LV structure (LV mass) and systolic (LVEF, Vs) and diastolic function, by pulse-wave Doppler (E/A ratio) and tissue Doppler imaging (Ve). LV volumes and LVEF were similar between groups. However, LV mass increased significantly and progressively (LVM/Ht2.7, in g/m2.7: 34.9 ± 6.7, 41.0 ± 9.5, 46.3 ± 11.0, P < 0.001); LV relaxation decreased progressively (Veglobal', in cm/s: 13.5 ± 2.8, 12.1 ± 3.0, 10.5 ± 2.2, P < 0.001) from Absent to Pre-Metabolic Syndrome to Metabolic Syndrome groups, respectively. Multiple variable analyses showed that diastolic blood pressure, waist circumference, and triglyceride levels were independent predictors of Ve after adjustment for LV mass.
Conclusion Patients with metabolic syndrome have LV diastolic dysfunction independent of LV mass. These functional abnormalities may partially explain the increased cardiovascular morbidity and mortality associated with metabolic syndrome.
Key Words: Metabolic syndrome • Echocardiography • Diastolic function • Tissue doppler imaging • Hypertension • Obesity
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