Karakurt Ozlem, Oztekin Sanem, Yazıhan Nuray, Akdemir Ramazan
Department of Cardiology, Dişkapi Yildırım Beyazit Training and Research Hospital, Ankara, Turkey.
Turk Kardiyol Dern Ars. 2011 Oct;39(7):549-56. doi: 10.5543/tkda.2011.01512.
Metabolic syndrome (MetS) has been shown to be independently associated with increased risk for incident heart failure and coronary artery disease. We investigated whether there was deterioration in right ventricular functions in MetS patients with preserved left ventricular functions and its association with the number of MetS components.
The study included 192 consecutive patients (148 women, 44 men; mean age 54.3 ± 8.5 years) with the diagnosis of MetS based on the NCEP-ATP III criteria and 20 healthy controls (12 women, 8 men; mean age 51.6 ± 8.4 years). All subjects underwent conventional and tissue Doppler (TDI) echocardiography to assess left and right ventricular functions, including right ventricular myocardial performance index (MPI) and tricuspid annular plane systolic excursion (TAPSE).
The number of MetS components were three in 43.8%, four in 31.3%, and five in 25% of the patients. Right ventricular TDI-derived MPI was higher in patients with MetS compared to controls [median 0.5 (range 0.2-3.3) vs. 0.3 (0.1-0.7), p=0.000]. This was possibly due to significantly shortened right ventricular ejection time in MetS patients (p<0.05). Although TAPSE was within the normal range in MetS patients, it was significantly decreased compared to controls (p=0.000), accompanied by significantly lower TDI-derived S wave, E wave, and E/A ratio (p=0.000). None of the MetS components were significantly correlated with right ventricular TDI-derived MPI. There was no association between the number of MetS components and echocardiographic parameters.
Our findings show that, despite preserved left ventricular systolic functions, both systolic and diastolic functions of the right ventricle deteriorate in MetS patients.
代谢综合征（MetS）已被证明与发生心力衰竭和冠状动脉疾病的风险增加独立相关。我们调查了左心室功能保留的MetS患者右心室功能是否恶化及其与MetS组分数量的关系。
该研究纳入了192例连续患者（148例女性，44例男性；平均年龄54.3±8.5岁），这些患者根据NCEP-ATP III标准诊断为MetS，以及20例健康对照者（12例女性，8例男性；平均年龄51.6±8.4岁）。所有受试者均接受常规和组织多普勒（TDI）超声心动图检查以评估左、右心室功能，包括右心室心肌做功指数（MPI）和三尖瓣环平面收缩期位移（TAPSE）。
43.8%的患者有3个MetS组分，31.3%的患者有4个组分，25%的患者有5个组分。与对照组相比，MetS患者右心室TDI衍生的MPI更高[中位数0.5（范围0.2 - 3.3）对0.3（0.1 - 0.7），p = 0.000]。这可能是由于MetS患者右心室射血时间显著缩短（p < 0.05）。虽然MetS患者的TAPSE在正常范围内，但与对照组相比显著降低（p = 0.000），同时TDI衍生的S波、E波和E/A比值显著降低（p = 0.000）。没有一个MetS组分与右心室TDI衍生的MPI显著相关。MetS组分数量与超声心动图参数之间没有关联。
我们的研究结果表明，尽管左心室收缩功能保留，但MetS患者右心室的收缩和舒张功能均恶化。
