[Myocardial structure and function in patients with metabolic syndrome--echocardiographic and ergospirometric...

Presently a lot of studies focus on metabolic syndrome. There are new studies regarding the relationship between metabolic syndrome (MS) and changes in myocardial structure and function and subsequent development of heart failure. The aim of the study was to assess the myocardial structure and function, particularly diastolic function, and to evaluate the exercise capacity in patients with metabolic syndrome.

53 patients with MS (defined according to NCEP ATP III criteria) and 33 individuals in control group were enrolled into the study. Echocardiographic examination (with evaluation of morphologic parameters, ejection fraction and diastolic function) and ergospirometry (to objectively assess the exercise capacity) were performed in all patients.

In patients with MS hypertension (100%) and abdominal obesity (98%) were the most frequent. In the studied group significantly lower E/A ratio (describing left ventricle relaxation) was observed in comparison to control group (E/A 1.0 +/- 0.05 vs. 1.29 +/- 0.11; p < 0.05). Diastolic dysfunction assessed with the use of E/A worsened with the number of metabolic syndrome elements (1.07 vs. 0.96 vs. 0.87 for 3, 4 and 5 metabolic syndrome elements respectively). Lower peak oxygen uptake (VO2 peak) was observed in patients with MS in comparison to control group (24 +/- 0.75 vs. 27 +/- 1.52 ml/kg/min; p < 0.05). There was the tendency to higher VE-CO2 slope index in patients with MS in comparison to control group (27 +/- 0.45 vs. 25 +/- 0.7; p = 0.057). VE-CO2 slope increased with the increase of the number of MS elements (26 vs. 28 vs. 29 for 3, 4 and 5 metabolic syndrome elements). There was significant positive correlation between E/A ratio and VO2 peak (r = 0.27; p < 0.05) and significant negative correlation between E/A ratio and VE-CO2 slope (r = -0.37; p < 0.01).

In patients with metabolic syndrome the significant decrease of exercise capacity assessed by ergospirometry and lower values of E/A ratio (that describes left ventricle relaxation) in comparison to control group. It seems that there is casual relation between these parameters and one may conclude that patients with MS are at risk of development of left ventricle dysfunction and in consequence heart failure.