title: Increased left ventricular arrhythmogenicity in metabolic syndrome and relationship with myocardial performance, risk factors for atherosclerosis, and low-grade inflammation.
abstract: Metabolic syndrome (MetS) is a clustering of cardiovascular risk factors recently associated with left ventricular dysfunction. Limited data exist on the association between MetS and ventricular arrhythmogenicity. This study examined differences in ventricular arrhythmogenicity assessed by classic (QT interval) and newer (spatial QRS-T angle [spQRS-Ta]) electrocardiographic markers in subjects with and without MetS. A total of 306 subjects, 153 with and 153 without MetS, matched for sex and age were examined. The spQRS-Ta, which vectorcardiographically quantifies the deviation between the directions of ventricular depolarization and repolarization, was measured using a computer-based electrocardiograph. Left ventricular mass index and myocardial performance were evaluated echocardiographically. The spQRS-Ta was significantly higher in subjects with in comparison with those without MetS. Left ventricular mass index, QT interval, and its dispersion were not different between the 2 groups. Left ventricular myocardial performance was worse in subjects with MetS and was associated with higher values of the spQRS-Ta. Multivariate linear regression analysis demonstrated MetS status as the strongest predictor of ventricular arrhythmogenicity. Addition of the high-sensitivity C-reactive protein in the model increased the explained variance of the spQRS-Ta by 11%. In conclusion, ventricular arrhythmogenicity is present in MetS and is associated with myocardial dysfunction, risk factors for atherosclerosis, and low-grade inflammation. The independent association between the spQRS-Ta and MetS implies that the clustering of the metabolic disturbances has additional prognostic information than its individual components in terms of ventricular arrhythmogenicity and may explain in part the excess cardiovascular risk in subjects with MetS.
authors.affiliation: First Department of Propaedeutic Medicine, Laiko General Hospital, Athens University Medical School, Athens 115 27, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Voulgari
authors.forename: Nicholas
authors.initials: N
authors.lastname: Tentolouris
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Papadogiannis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Moyssakis
authors.forename: Despoina
authors.initials: D
authors.lastname: Perrea
authors.forename: Despoina
authors.initials: D
authors.lastname: Kyriaki
authors.forename: Nicholas
authors.initials: N
authors.lastname: Katsilambros
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D050197:Atherosclerosis / Q000209:etiology*; D002097:C-Reactive Protein / Q000032:analysis; D009202:Cardiomyopathies / Q000150:complications / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D015150:Echocardiography, Doppler; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007249:Inflammation / Q000097:blood / Q000209:etiology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein