title: Metabolic syndrome is associated with abnormal left ventricular diastolic function independent of left ventricular mass.
abstract: OBJECTIVE
  To characterize the extent to which metabolic syndrome criteria predict left ventricular (LV) structure and function.
  
  
  RESULTS
  Metabolic syndrome criteria were assessed in 607 adults with normal LV function. The cohort was grouped according to the number of criteria satisfied: (1) Absent (0 criteria, n = 110); (2) Pre-Metabolic Syndrome (1-2 criteria, n = 311); and (3) Metabolic Syndrome (>or=3 criteria, n = 186). Echocardiography was used to assess LV structure (LV mass) and systolic (LVEF, Vs) and diastolic function, by pulse-wave Doppler (E/A ratio) and tissue Doppler imaging (Ve). LV volumes and LVEF were similar between groups. However, LV mass increased significantly and progressively (LVM/Ht(2.7), in g/m(2.7): 34.9 +/- 6.7, 41.0 +/- 9.5, 46.3 +/- 11.0, P < 0.001); LV relaxation decreased progressively (Ve(global'), in cm/s: 13.5 +/- 2.8, 12.1 +/- 3.0, 10.5 +/- 2.2, P < 0.001) from Absent to Pre-Metabolic Syndrome to Metabolic Syndrome groups, respectively. Multiple variable analyses showed that diastolic blood pressure, waist circumference, and triglyceride levels were independent predictors of Ve after adjustment for LV mass.
  
  
  CONCLUSIONS
  Patients with metabolic syndrome have LV diastolic dysfunction independent of LV mass. These functional abnormalities may partially explain the increased cardiovascular morbidity and mortality associated with metabolic syndrome.
authors.affiliation: Cardiovascular Imaging and Clinical Research Core Laboratory, Campus Box 8086, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA. lfuentes@wustl.edu
authors.forename: Lisa
authors.initials: L
authors.lastname: de las Fuentes
authors.forename: Angela L
authors.initials: AL
authors.lastname: Brown
authors.forename: Santhosh J
authors.initials: SJ
authors.lastname: Mathews
authors.forename: Alan D
authors.initials: AD
authors.lastname: Waggoner
authors.forename: Pablo F
authors.initials: PF
authors.lastname: Soto
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Gropler
authors.forename: Víctor G
authors.initials: VG
authors.lastname: Dávila-Román
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D049629:Waist-Hip Ratio