Abstract 11573: Metabolic Syndrome is Associated With Diastolic Dysfunction Independent of Left Ventricular Hypertrophy
Background: While Metabolic syndrome (MetS) is commonly associated with diastolic dysfunction (DD) and left ventricular hypertrophy (LVH), it is not clear whether DD can occur independent of LVH.
Methods: We recruited 95 consecutive participants without overt cardiovascular disease who met criteria for MetS (3 or more risk factors), and 21 controls (0 risk factors for MetS). All participants underwent clinical evaluation and transthoracic echocardiography with tissue Doppler imaging. The associations of MetS and measures of cardiac structure and function were assessed using multivariable linear regression. Hierarchical models were constructed, first adjusting for age and sex, and then further adjusting for systolic blood pressure, use of anti-hypertensive medications, and LV mass.
Results: A total of 116 subjects were included in our study: 95 subjects with MetS (mean age 46 years, 74% female) and 21 controls without MetS (mean age 42 years, 62% female). In age- and sex-adjusted analyses (Table, Model 1) MetS was associated with higher left atrial (LA) diameter, higher LV mass, lower E/A ratio, and lower mean e’ (P<0.001 for all). These associations were independent of blood pressure and anti-hypertensive medication use (Table, Model 2). In contrast, there were no differences in LV dimensions or LV ejection fraction between groups. After additionally adjusting diastolic function measures for LV mass, MetS remained independently associated with higher LA diameter, lower E/A ratio and lower mean e’ (Table, Model 3; P≤0.001 for all). Specifically, subjects with MetS had a 1.7 cm/s lower mean e’ compared with controls (P=0.007).
Conclusion: MetS was associated with subclinical DD independent of LV mass, as reflected by higher LA diameter, lower E/A ratio, and lower mean e’. These findings suggest that MetS can lead to the development of DD via a mechanism(s) independent of hypertrophy.
- © 2013 by American Heart Association, Inc.