Left Ventricular Structural and Functional Changes in the Metabolic Syndrome
Azra Mahmud MD, PhD
From the Department of Pharmacology and Therapeutics and Hypertension Clinic;
Search for more papers by this authorIbrahim Almuntaser MD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorAngie Brown MD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorGerard King PhD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorPeter Crean MD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorJohn Feely MD
From the Department of Pharmacology and Therapeutics and Hypertension Clinic;
Search for more papers by this authorAzra Mahmud MD, PhD
From the Department of Pharmacology and Therapeutics and Hypertension Clinic;
Search for more papers by this authorIbrahim Almuntaser MD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorAngie Brown MD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorGerard King PhD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorPeter Crean MD
Department of Cardiology, Trinity College and St. James’s Hospital, Dublin, Ireland
Search for more papers by this authorJohn Feely MD
From the Department of Pharmacology and Therapeutics and Hypertension Clinic;
Search for more papers by this authorAbstract
To test the hypothesis that the cardiac structural and functional abnormalities of the metabolic syndrome (MS) are independent of body mass index (BMI), 160 untreated patients (aged 47±1 years [mean ± SEM], 53% male) underwent 2-dimensional echocardiography and tissue Doppler imaging and evaluation for MS. Participants with MS and controls were similar in age, BMI, and ejection fraction, but those with MS had greater left ventricular relative wall thickness (RWT) (0.43±0.008 vs 0.39±0.005, P<.001), reduced midwall fractional shortening (MFS) (13%±0.3% vs 14.2%±0.3%, P<.05), and reduced peak mitral annular velocity (Em) (9.9±0.5 vs 12.3±0.5 cm/sec, P<.01) than controls. There was a linear relationship between the number of features of MS and Em velocity (P<.001), RWT (P<.001), and MFS (P<.05). In a stepwise multiple regression analysis adjusting for likely determinants, MS was an independent predictor of Em in addition to age and nonindexed left ventricular mass. MS is associated with left ventricular concentric remodeling and reduced systolic and diastolic function independent of BMI.
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