La Carrubba Salvatore, Todaro Maria Chiara, Zito Concetta, Antonini-Canterin Francesco, Monte Ines Paola, Caso Pio, Colonna Paolo, de Gregorio Cesare, Pezzano Antonio, Benedetto Frank, Salvo Giovanni Di, Carerj Scipione, Bello Vitantonio Di
Internal Medicine, A.O.R. Villa Sofia Cervello, Palermo, Italy.
Cardiology, University of Messina, Messina, Italy.
J Cardiovasc Echogr. 2013 Oct-Dec;23(4):96-101. doi: 10.4103/2211-4122.127410.
Metabolic syndrome (MS) is a cluster of interrelated common clinical disorders, including obesity, insulin resistance, glucose intolerance, hypertension and dyslipidemia, associated with a greater risk of atherosclerotic cardiovascular disease than any of its individual components. Although MS is associated with increased cardiovascular risk (CVR), its relationship with heart failure (HF) and left ventricular (LV) dysfunction is not fully understood.
We sought to determine whether MS is associated to LV systolic and diastolic dysfunction in a sample of patients with MS and no symptoms for HF.
We enrolled 6422 consecutive asymptomatic patients admitted to echo-lab for a routine echocardiogram. We calculated LV systolic and diastolic function, by Simpson biplane method and validated Doppler parameters, respectively. MS was diagnosed if three or more CVR factors were found.
LV systolic function was evaluated in 6175 patients (96.2%). In the group of patients without MS ( = 5630), the prevalence of systolic dysfunction was 10.8% ( = 607) while in the group of patients with MS ( = 545) it was 12.5% ( = 87), (RR1.57; CI 95% 1.2-2.0; < 0.001). Diastolic function was evaluated in 3936 patients (61.3%). In the group of patients without MS ( = 3566) the prevalence of diastolic dysfunction was 33.3% ( = 1187), while in patients with MS ( = 370) it was 45.7% ( = 169), (RR1.68; CI95% 1.3-2.0; < 0.001). After adjustment for age and gender, MS proved to be an independent predictor of LV systolic and diastolic dysfunction.
Our data show that asymptomatic LV systolic and diastolic dysfunction, is correlated with MS and demonstrate that echocardiography is a useful tool to detect patients at high risk for HF. Echocardiography in asymptomatic patients with MS may lead to a therapy initiation at early stages to prevent future cardiovascular events and HF.
代谢综合征（MS）是一组相互关联的常见临床病症，包括肥胖、胰岛素抵抗、葡萄糖耐量异常、高血压和血脂异常，与动脉粥样硬化性心血管疾病的风险相比，其任何单个组成部分的风险都更高。虽然MS与心血管风险（CVR）增加相关，但其与心力衰竭（HF）和左心室（LV）功能障碍的关系尚未完全明确。
我们试图确定在无HF症状的MS患者样本中，MS是否与LV收缩和舒张功能障碍相关。
我们纳入了6422例连续因常规超声心动图检查而入住超声心动图实验室的无症状患者。我们分别采用双平面辛普森法和经过验证的多普勒参数计算LV收缩和舒张功能。如果发现三个或更多CVR因素，则诊断为MS。
对6175例患者（96.2%）进行了LV收缩功能评估。在无MS的患者组（n = 5630）中，收缩功能障碍的患病率为10.8%（n = 607），而在MS患者组（n = 545）中为12.5%（n = 87），（相对危险度1.57；95%置信区间1.2 - 2.0；P < 0.001）。对3936例患者（6 l.3%）进行了舒张功能评估。在无MS的患者组（n = 3566）中，舒张功能障碍的患病率为33.3%（n = 1187），而在MS患者组（n = 370）中为45.7%（n = 169），（相对危险度1.68；95%置信区间l.3 - 2.0；P < 0.001）。在对年龄和性别进行校正后，MS被证明是LV收缩和舒张功能障碍的独立预测因素。
我们的数据表明，无症状的LV收缩和舒张功能障碍与MS相关，并证明超声心动图是检测HF高危患者的有用工具。对无症状MS患者进行超声心动图检查可能会在早期启动治疗，以预防未来的心血管事件和HF。
