The role of metabolic syndrome in right and left ventricular remodeling and function in patients with preserved left ventricular systolic function

Objective: To evaluate the impact of metabolic syndro-me (MetS) on main echocardiographic parameters of right (RV) and left ventricular (LV) structure and func-tion.

Methods: Our study included 44 patients with MetS and 44 subjects without MetS (control group). MetS was defined by ≥3 criteria of International Diabetes Federation and American Heart Association/Natio-nal Heart, Lung, and Blood Institute. All participants underwent complete 2D, pulsed and tissue Doppler echocardiography for the assessment of LV and RV structure and function. We assessed LV diameters, re-lative wall thickness (RWT), mass index (LVM/Ht2.7), ejection fraction, early diastolic (Em) and late diastolic mitral flow (Am, pulse Doppler) ratio, early diastolic tissue Doppler velocity of the septal segment of mitral annulus (e’), Em/e’, LV Tei index. Also we determined RV diameters, RV wall thickness, end-diastolic (EDA) and end-systolic area (ESA), TAPSE, early diastolic (Et) and late diastolic (At) tricuspid flow ratio, early diastolic tissue Doppler velocity of the tricuspid annulus (e’t), Et/e’t ratio, RV Tei index.

Results: Comparison of LV and RV diameters and systolic function revealed no statistically important difference between the groups (for all the parameters P<0.01). RWT and LVM/Ht2.7 were significantly in-creased in the MetS group (respectively: 0.44 ± 0.09 vs. 0.39 ± 0.10, P<0.001; 52.4 ± 11.2 g/m2.7 vs. 49.4 ± 10.3 g/m2.7, P<0.001). The parameters of LV diastolic and global function were significantly deteriorated in the MetS group: Em/Am 0.83 ± 0.21 vs. 1.19 ± 0.23, P<0.01; Em/e’ 9,21 ± 1,65 vs. 6.88 ± 1.59, P<0.01; LV Tei index 0.46 ± 0.11 vs. 0.38 ± 0.09, P=0.0251). RV EDA (P=0.002) and RV ESA (P=0.038) were significantly decreased in subjects with MetS. RV wall thickness was higher in subjects with MetS (0.45 ± 0.10cm vs. 0.3408cm, P<0.01). Parameters of RV diastolic (Et/At, Et/e’t, all P<0.01) and global function (RV Tei index, P<0.0001) were significantly changed in MetS group.

Conclusions: Our findings support that metabolic syndrome has an impact on RV and LV diastolic and global (determined by Tei index) function and, also, contributes to biventricular remodeling.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)