Subclinical systolic and diastolic dysfunctions in patients with metabolic syndrome and angiographically normal coronary arteries: An echocardiographic study

J Clin Ultrasound. 2018 Mar;46(3):195-201. doi: 10.1002/jcu.22568. Epub 2017 Dec 6.

Abstract

Background: The metabolic syndrome (MetS), as a combination of cardiovascular risk factors, is associated with subclinical cardiovascular diseases. We sought to evaluate the subclinical myocardial dysfunctions using echocardiography in patients with normal coronary arteries.

Materials and methods: In this cross-sectional study, we assessed 50 consecutive patients with angiographically-proven normal coronary arteries and a left ventricular (LV) ejection fraction (EF) ≥55%. The diagnosis of MetS was based on the National Cholesterol Education Program/Adult Treatment Panel III criteria. All patients were examined using conventional and two-dimensional speckle tracking echocardiography for evaluating the myocardial functions.

Results: The patients' mean age was 52.3 ± 8.3 years with 32 females (64%). LV EF, mass index, and full volume were comparable between groups. The LV myocardial performance index (0.40 ± 0.13 vs. 0.32 ± 0.10; P = .027), global longitudinal strain (GLS, -15.8 ± 4.5 vs. -19.7 ± 2.1; P < .001), and global circumferential strain (-17.9 ± 6.1 vs. -21.5 ± 3.3; P = .014) were different between patients with or without MetS, respectively. The GLS discriminated patients with MetS (area under the curve = 0.837, sensitivity 80%, specificity 88%, P < .001).

Conclusions: In MetS without coronary artery disease, echocardiography demonstrated subclinical systolic and diastolic dysfunction.

Keywords: diastolic function; metabolic syndrome; speckle tracking echocardiography; systolic function.

MeSH terms

  • Coronary Angiography*
  • Coronary Vessels / physiology*
  • Cross-Sectional Studies
  • Diastole / physiology*
  • Echocardiography
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / physiopathology
  • Middle Aged
  • Sensitivity and Specificity
  • Systole / physiology*
  • Ventricular Dysfunction, Left / diagnostic imaging
  • Ventricular Dysfunction, Left / etiology*
  • Ventricular Dysfunction, Left / physiopathology