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Metabolic syndrome associates with left atrial dysfunction.

K Nyman1, M Granér2, M O Pentikäinen3

  • 1HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Nutrition, Metabolism, and Cardiovascular Diseases : NMCD
|May 17, 2018
PubMed
Summary

Metabolic syndrome (MetS) is linked to subclinical left atrial (LA) dysfunction in men. Visceral obesity and insulin resistance are key factors contributing to this dysfunction, potentially impacting atrial fibrillation risk.

Keywords:
Atrial remodelingCardiac steatosisCardiovascular magnetic resonanceEjection fractionLeft atrialMetabolic syndromeObesityProton magnetic resonance spectroscopyVisceral adipose tissue

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Area of Science:

  • Cardiology
  • Metabolic Health
  • Medical Imaging

Background:

  • Obesity and metabolic syndrome (MetS) are recognized risk factors for atrial fibrillation (AF).
  • Limited data exist on the specific impact of ectopic fat depots and cardiometabolic risk factors on left atrial (LA) function.

Purpose of the Study:

  • To investigate the effects of cardiac, hepatic, and intra-abdominal ectopic fat depots on LA function.
  • To evaluate the influence of cardiometabolic risk factors on LA function in non-diabetic males.

Main Methods:

  • Utilized 1.5T 1H-magnetic resonance spectroscopy for myocardial and hepatic triglyceride content.
  • Employed magnetic resonance imaging (MRI) to assess LA and left ventricular function, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and epicardial/pericardial fat.
  • Assessed LA volumes using a novel three-chamber orientation MRI approach in men with and without MetS.

Main Results:

  • Patients with MetS exhibited significantly lower LA ejection fraction (EF) compared to controls (44% vs. 49%, p=0.013) without LA enlargement, indicating subclinical LA dysfunction.
  • LA EF showed negative correlations with waist circumference, BMI, SAT, VAT, fasting insulin, and HOMA-IR, and a positive correlation with HDL cholesterol.
  • Visceral adipose tissue (VAT) emerged as the strongest predictor of reduced LA EF.

Conclusions:

  • Metabolic syndrome is associated with subclinical left atrial dysfunction in men.
  • Visceral obesity and insulin resistance are significant contributors to LA dysfunction in MetS.
  • Further research is warranted to understand the role of atrial remodeling in AF development.