Aksoy Sukru, Durmuş Gündüz, Özcan Serhan, Toprak Ercan, Gurkan Ufuk, Oz Dilaver, Canga Yigit, Karatas Baran, Duman Dursun
Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Turkey.
J Cardiol. 2014 Sep;64(3):194-8. doi: 10.1016/j.jjcc.2014.01.002. Epub 2014 Feb 10.
It has been shown that left ventricular diastolic dysfunction (LVDD) develops in patients with metabolic syndrome (MetS). However, there is not sufficient evidence in the literature to determine whether this condition is due to increase in blood pressure, which is frequently encountered in MetS. The purpose of this study was to test the hypothesis whether LVDD in MetS is independent from the presence of hypertension.
A total of 60 patients diagnosed with MetS and 30 healthy people, who were age- and gender-matched with the patient group, were included in the study as the control group. In the study group, 30 of the patients were normotensive whereas the other 30 had hypertension. Conventional echocardiographic examinations and tissue Doppler imaging were performed besides measurements of demographic and biochemical parameters.
In the hypertensive MetS group, early diastolic filling flow (E), early diastolic mitral annular velocity (E'), and E/A ratio were significantly lower compared to the control group. Late diastolic filling flow (A), deceleration time (DT), late diastolic mitral annular velocity (A'), and E/E' ratio were higher in the hypertensive MetS group than the control group. In the normotensive MetS group, E, E', and E/A ratio were also lower compared to the control group whereas DT, A', and E/E' ratio were higher.
These findings support the idea that LVDD may develop in patients with MetS even in the absence of hypertension. In addition, co-existence of hypertension with MetS contributes to further worsening of diastolic functions.
已有研究表明，代谢综合征（MetS）患者会出现左心室舒张功能障碍（LVDD）。然而，文献中尚无足够证据确定这种情况是否归因于代谢综合征中常见的血压升高。本研究的目的是检验代谢综合征中的左心室舒张功能障碍是否独立于高血压存在这一假设。
本研究纳入了60例诊断为代谢综合征的患者以及30名年龄和性别与患者组匹配的健康人作为对照组。在研究组中，30例患者血压正常，另外30例患有高血压。除了测量人口统计学和生化参数外，还进行了常规超声心动图检查和组织多普勒成像。
与对照组相比，高血压代谢综合征组的舒张早期充盈血流（E）、舒张早期二尖瓣环速度（E'）和E/A比值显著降低。高血压代谢综合征组的舒张晚期充盈血流（A）、减速时间（DT）、舒张晚期二尖瓣环速度（A'）和E/E'比值高于对照组。在血压正常的代谢综合征组中，与对照组相比，E、E'和E/A比值也较低，而DT、A'和E/E'比值较高。
这些发现支持以下观点，即即使在没有高血压的情况下，代谢综合征患者也可能出现左心室舒张功能障碍。此外，高血压与代谢综合征并存会导致舒张功能进一步恶化。
