Regional myocardial function abnormalities are associated with macro- and microcirculation dysfunction in the...

Area of Science:

• Cardiology
• Vascular Biology
• Metabolic Disorders

Background:

• Metabolic syndrome (MetS) is associated with myocardial and vascular dysfunction.
• The relationship between macro- and microcirculatory vasoreactivity and left ventricular (LV) myocardial function in MetS is not well understood.

Purpose of the Study:

• To investigate the interrelationships between macro- and microcirculatory vasoreactivity and LV myocardial function in MetS patients.
• To identify predictors of LV myocardial dysfunction in MetS.

Main Methods:

• Eighty-eight MetS patients and 44 controls underwent assessment of LV global longitudinal strain (GLS) using Vector Velocity Imaging.
• Macrocirculatory and microcirculatory vasoreactivity were assessed via brachial artery flow-mediated and nitrate-mediated dilation, and laser Doppler flowmetry.
• Carotid intima-media thickness (cIMT) was measured.

Main Results:

• MetS patients exhibited reduced GLS, increased cIMT, and impaired endothelial and smooth muscle function in the brachial artery and skin microcirculation compared to controls.
• Significant correlations were observed between GLS and vascular parameters.
• cIMT and microcirculatory endothelial function independently predicted GLS.

Conclusions:

• Abnormalities in myocardial function, and small and large artery vascular function coexist and are closely associated in MetS.
• Microvascular dysfunction plays a role in the pathogenesis of LV myocardial dysfunction in MetS.