Subclinical Myocardial Dysfunction in Metabolic Syndrome Patients without Hypertension
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Background: The aim of this study was to evaluate myocardial function in patients with non-hypertensive metabolic syndrome. Methods: We selected metabolic syndrome patients (n = 42) without evidence of hypertension and compared them to agematched control individuals (n = 20). All patients were evaluated by two-dimensional and tissue Doppler echocardiography including tissue Doppler derived strain and strain rate measurements. Results: There were no significant differences between the two groups in mitral E and A inflow velocities or the E/A ratio. However, systolic and early diastolic myocardial velocities, and strain rate were significantly lower in patients with metabolic syndrome than in the control group (all p < 0.05). Multiple stepwise regression analyses revealed that age, waist circumference,and systolic blood pressure were independently associated with peak systolic myocardial velocity. Conclusion: These results indicate that metabolic syndrome patients without hypertension may have decrease of myocardial systolic and early diastolic velocities on tissue Doppler imaging, even if they appear to have normal systolic and diastolic function on conventional echocardiography.
Abstract
Background: The aim of this study was to evaluate myocardial function in patients with non-hypertensive metabolic syndrome. Methods: We selected metabolic syndrome patients (n = 42) without evidence of hypertension and compared them to agematched control individuals (n = 20). All patients were evaluated by two-dimensional and tissue Doppler echocardiography including tissue Doppler derived strain and strain rate measurements. Results: There were no significant differences between the two groups in mitral E and A inflow velocities or the E/A ratio. However, systolic and early diastolic myocardial velocities, and strain rate were significantly lower in patients with metabolic syndrome than in the control group (all p < 0.05). Multiple stepwise regression analyses revealed that age, waist circumference,and systolic blood pressure were independently associated with peak systolic myocardial velocity. Conclusion: These results indicate that metabolic syndrome patients without hypertension may have decrease of myocardial systolic and early diastolic velocities on tissue Doppler imaging, even if they appear to have normal systolic and diastolic function on conventional echocardiography.
참고문헌 (29)
- Ford ES, "Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey", JAMA, 287, pp.356~359 (2002)
- Choi KM, "International Diabetes Federation. Prevalence and cardiovascular disease risk of the metabolic syndrome using National Cholesterol Education Program and International Diabetes Federation definitions in the Korean population", Metabolism, 56, pp.552~558 (2007)
- 최성희, "The Prevalence of the Metabolic Syndrome in Korean Adults: Comparison of WHO and NCEP Criteria", Yonsei Medical Journal, 46(2), pp.198~205 (2005), 연세대학교의과대학
- Isomaa B, "Cardiovascular morbidity and mortality associated with the metabolic syndrome", Diabetes Care, 24, pp.683~689 (2001)
- Lakka HM, "The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men", JAMA, 288, pp.2709~2716 (2002)
- Malik S, "Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults", Circulation, 110, pp.1245~1250 (2004)
- McNeill AM, "The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study", Diabetes Care, 28, pp.385~390 (2005)
- Ingelsson E, "Metabolic syndrome and risk for heart failure in middle-aged men", Heart, 92, pp.1409~1413 (2006)
- de Simone G, "Metabolic syndrome and left ventricular hypertrophy in the prediction of cardiovascular events: the Strong Heart Study", Nutr Metab Cardiovasc Dis, 19, pp.98~104 (2009)
- Chinali M, "Comparison of cardiac structure and function in American Indians with and without the metabolic syndrome (the Strong Heart Study)", Am J Cardiol, 93, pp.40~44 (2004)
- Masugata H, "Left ventricular diastolic dysfunction as assessed by echocardiography in metabolic syndrome", Hypertens Res, 29, pp.897~903 (2006)
- de las Fuentes L, "Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass", Eur Heart J, 28, pp.553~559 (2007)
- Wong CY, "Myocardial and vascular dysfunction and exercise capacity in the metabolic syndrome", Am J Cardiol, 96, pp.1686~1691 (2005)
- Grundy SM, "American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association", National Heart, Lung, and Blood Institute Scientific Statement, 2005, pp.112, 2735~2752
- Chobanian AV, "National Heart, Lung, and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report", JAMA, 289, pp.2560~2572 (2003)
- Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, "Report of the expert committee on the diagnosis and classification of diabetes mellitus", Diabetes Care, 26(1), pp.5~20 (2003)
- Obesity: preventing and managing the global epidemic. Report of a WHO consultation, , 1~253, pp.World Health Organ Tech Rep Ser 2000;894:i-xii (2000)
- Lang RM, "American Society of Echocardiography’s Nomenclature and Standards Committee; Task Force on Chamber Quantification; American College of Cardiology Echocardiography Committee; American Heart Association; European Association of Echocardiography, European Society of Cardiology. Recommendations for chamber quantification", Eur J Echocardiogr, 7, pp.79~108 (2006)
- Lester SJ, "Unlocking the mysteries of diastolic function: deciphering the Rosetta Stone 10 years later", J Am Coll Cardiol, 51, pp.679~689 (2008)
- Okin PM, "Relationship of the electrocardiographic strain pattern to left ventricular structure and function in hypertensive patients: the LIFE study. Losartan Intervention For End point", J Am Coll Cardiol, 38, pp.514~520 (2001)
- Von Bibra H, "Tissue Doppler imaging for the detection and quantitation of myocardial dysfunction in patients with type 2 diabetes mellitus", Diab Vasc Dis Res, 2, pp.24~30 (2005)
- Nagueh SF, "Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures", J Am Coll Cardiol, 30, pp.1527~1533 (1997)
- Sherif F. Nagueh, "Tissue Doppler Imaging for the Assessment of Left Ventricular Diastolic Function", Journal of Cardiovascular Ultrasound, 16(3), pp.76~79 (2008), 한국심초음파학회
- Park TH, "Acute effect of nonsurgical septal reduction therapy on regional left ventricular asynchrony in patients with hypertrophic obstructive cardiomyopathy", Circulation, 106, pp.412~415 (2002)
- Takemoto Y, "Analysis of the interaction between segmental relaxation patterns and global diastolic function by strain echocardiography", J Am Soc Echocardiogr, 18, pp.901~906 (2005)
- Palaniappan L, "Insulin Resistance Atherosclerosis Study. Predictors of the incident metabolic syndrome in adults: the Insulin Resistance Atherosclerosis Study", Diabetes Care, 27, pp.788~793 (2004)
- Talini E, "Early impairment of left ventricular function in hypercholesterolemia and its reversibility after short term treatment with rosuvastatin A preliminary echocardiographic study", Atherosclerosis, 197, pp.346~354 (2008)
- Schillaci G, "Prognostic significance of left ventricular diastolic dysfunction in essential hypertension", J Am Coll Cardiol, 39, pp.2005~2011 (2002)
- Bella JN, "Mitral ratio of peak early to late diastolic filling velocity as a predictor of mortality in middle-aged and elderly adults: the Strong Heart Study", Circulation, 105, pp.1928~1933 (2002)
