title: Are the metabolic syndrome, blood pressure pattern, and their interaction responsible for the right ventricular remodeling?
abstract: OBJECTIVE
  The aim of our study was to define the relationship between the metabolic syndrome (MS), nondipping pattern, and their interaction on right ventricular (RV) structural and functional changes in untreated hypertensive patients.
  
  
  METHODS
  This cross-sectional study included 318 recently diagnosed hypertensive patients. MS was defined by the presence of at least 3 National Cholesterol Education Program's Adult Treatment Panel III criteria. All patients underwent 24-h ambulatory blood pressure monitoring and a complete two-dimensional echocardiography examination.
  
  
  RESULTS
  MS was found in 144 (45%) hypertensive patients and the nondipping pattern was detected in 147 (46%) patients. Hypertensive patients with MS had higher 24-h and night-time blood pressure levels in comparison with non-MS patients with the same nocturnal blood pressure pattern. RV wall thickness was significantly increased and RV diastolic function was significantly deteriorated in nondippers (with and without MS), but still more impaired in MS patients. MS, nondipping pattern, and their interaction had a huge impact on RV wall thickness, parameters of RV diastolic function (E/At, E/e't, e'/a't), as well as RV global function estimated by the myocardial performance index. Among the MS criteria, only fasting glucose level and abdominal obesity were associated independently with RV hypertrophy, diastolic, and global dysfunction.
  
  
  CONCLUSIONS
  MS, nondipping pattern, and their interaction significantly impact RV structure, diastolic, and global function. Fasting glucose level and abdominal obesity are the most important MS criteria for RV remodeling in arterial hypertension.
authors.affiliation: Department of Cardiology, University Clinical Hospital Center 'Dr Dragisa Misovic', Belgrade, Serbia. marijana_tadic@hotmail.com
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Branislava
authors.initials: B
authors.lastname: Ivanovic
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D003430:Cross-Sectional Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications*; D017380:Hypertrophy, Right Ventricular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D014463:Ultrasonography; D020257:Ventricular Remodeling