title: Exercise reveals impairments in left ventricular systolic function in patients with metabolic syndrome.
abstract: Metabolic syndrome (MetS) is the manifestation of a cluster of cardiovascular risk factors and is associated with a threefold increase in the risk of cardiovascular morbidity and mortality, which is suggested to be mediated, in part, by resting left ventricular (LV) systolic dysfunction. However, to what extent resting LV systolic function is impaired in MetS is controversial, and there are no data indicating whether LV systolic function is impaired during exercise. Accordingly, the objective of this study was to examine comprehensively the LV and arterial responses to exercise in individuals with MetS without diabetes and/or overt cardiovascular disease in comparison to a healthy control population. Cardiovascular function was characterized using Doppler echocardiography and gas exchange in individuals with MetS (n = 27) versus healthy control subjects (n = 20) at rest and during peak exercise. At rest, individuals with MetS displayed normal LV systolic function but reduced LV diastolic function compared with healthy control subjects. During peak exercise, individuals with MetS had impaired contractility, pump performance and vasodilator reserve capacity versus control subjects. A blunted contractile reserve response resulted in diminished arterial-ventricular coupling reserve and limited aerobic capacity in individuals with MetS versus control subjects. These findings are of clinical importance, because they provide insight into the pathophysiological changes in MetS that may predispose this population of individuals to an increased risk of cardiovascular morbidity and mortality.
authors.affiliation: P. D. Chantler: West Virginia University, 1 Medical Center Drive, PO Box 9227, Morgantown, WV 26508, USA. pchantler@hsc.wvu.edu.
authors.forename: Sara B
authors.initials: SB
authors.lastname: Fournier
authors.forename: Brian L
authors.initials: BL
authors.lastname: Reger
authors.forename: David A
authors.initials: DA
authors.lastname: Donley
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Bonner
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Warden
authors.forename: Wissam
authors.initials: W
authors.lastname: Gharib
authors.forename: Conard F
authors.initials: CF
authors.lastname: Failinger
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Olfert
authors.forename: Jefferson C
authors.initials: JC
authors.lastname: Frisbee
authors.forename: I Mark
authors.initials: IM
authors.lastname: Olfert
authors.forename: Paul D
authors.initials: PD
authors.lastname: Chantler
mesh_terms: D003971:Diastole / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008875:Middle Aged; D013599:Systole / Q000502:physiology*; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology*
references.citation: Circulation. 2004 Sep 7;110(10):1245-50
references.pmid: 15326067
references.citation: Circulation. 1997 Apr 1;95(7):1837-43
references.pmid: 9107171
references.citation: Hypertension. 2000 Jun;35(6):1270-7
references.pmid: 10856276
references.citation: Cardiol Clin. 2011 Aug;29(3):447-59
references.pmid: 21803232
references.citation: Am J Physiol Heart Circ Physiol. 2003 Feb;284(2):H744-50
references.pmid: 12414443
references.citation: J Am Coll Cardiol. 2004 Apr 21;43(8):1388-95
references.pmid: 15093872
references.citation: J Am Coll Cardiol. 2001 Sep;38(3):796-802
references.pmid: 11527636
references.citation: Circulation. 2001 Feb 13;103(6):820-5
references.pmid: 11171789
references.citation: Circulation. 2006 Nov 14;114(20):2138-47
references.pmid: 17088459
references.citation: J Am Coll Cardiol. 2012 Jan 31;59(5):455-61
references.pmid: 22281248
references.citation: Am J Physiol Heart Circ Physiol. 2008 Jul;295(1):H145-53
references.pmid: 18456731
references.citation: Circulation. 1987 Dec;76(6):1422-36
references.pmid: 3454658
references.citation: Eur J Heart Fail. 2013 Jul;15(7):776-85
references.pmid: 23426022
references.citation: Hypertension. 2010 Jul;56(1):91-8
references.pmid: 20458004
references.citation: J Am Coll Cardiol. 2004 Aug 4;44(3):611-7
references.pmid: 15358029
references.citation: Mayo Clin Proc. 2008 Dec;83(12):1350-7
references.pmid: 19046554
references.citation: Diabetes Res Clin Pract. 2009 Mar;83(3):300-7
references.pmid: 19167773
references.citation: Atherosclerosis. 2010 May;210(1):155-9
references.pmid: 20035939
references.citation: Am J Cardiol. 2000 Feb 15;85(4):473-7
references.pmid: 10728953
references.citation: Front Physiol. 2012 May 07;3:90
references.pmid: 22586401
references.citation: Stroke. 2003 May;34(5):1203-6
references.pmid: 12677025
references.citation: Circ Arrhythm Electrophysiol. 2013 Feb;6(1):212-7
references.pmid: 23424223
references.citation: Cardiology. 2002;98(1-2):33-9
references.pmid: 12373045
references.citation: Hypertension. 2007 Jan;49(1):55-61
references.pmid: 17088448
references.citation: Atherosclerosis. 2009 Mar;203(1):228-35
references.pmid: 18602106
references.citation: J Appl Physiol (1985). 2008 Oct;105(4):1342-51
references.pmid: 18617626
references.citation: Am J Cardiol. 2005 Dec 15;96(12):1686-91
references.pmid: 16360358
references.citation: J Am Coll Cardiol. 2001 Dec;38(7):2028-34
references.pmid: 11738311
references.citation: Am Heart J. 2004 Nov;148(5):789-94
references.pmid: 15523308
references.citation: J Phys Act Health. 2012 May;9(4):549-53
references.pmid: 22592874
references.citation: BMC Cardiovasc Disord. 2007 Jun 07;7:17
references.pmid: 17555566
references.citation: Diabetes Care. 2011 Jan;34(1):216-9
references.pmid: 20889854
references.citation: Circulation. 2002 Apr 23;105(16):1928-33
references.pmid: 11997279
references.citation: J Am Soc Echocardiogr. 1993 Mar-Apr;6(2):186-97
references.pmid: 8481247
references.citation: Comp Biochem Physiol A Mol Integr Physiol. 2002 Aug;132(4):699-721
references.pmid: 12095857
references.citation: Hypertension. 2006 May;47(5):881-6
references.pmid: 16585414
references.citation: J Cardiometab Syndr. 2009 Spring;4(2):81-8
references.pmid: 19614794
references.citation: Hypertension. 2009 Sep;54(3):558-66
references.pmid: 19581507
references.citation: Dis Model Mech. 2009 May-Jun;2(5-6):231-7
references.pmid: 19407331
references.citation: Eur J Echocardiogr. 2006 Mar;7(2):79-108
references.pmid: 16458610
references.citation: Am J Physiol Heart Circ Physiol. 2005 Nov;289(5):H2059-65
references.pmid: 15964929
references.citation: J Am Soc Echocardiogr. 1995 Mar-Apr;8(2):185-97
references.pmid: 7756003
references.citation: Curr Diab Rep. 2006 Aug;6(4):279-86
references.pmid: 16879779
references.citation: J Cardiovasc Ultrasound. 2011 Dec;19(4):176-82
references.pmid: 22259660
references.citation: J Am Coll Cardiol. 2010 Mar 30;55(13):1318-27
references.pmid: 20338492
references.citation: Eur Heart J. 2010 Mar;31(5):602-13
references.pmid: 19942601
references.citation: J Am Coll Cardiol. 2010 Sep 7;56(11):845-54
references.pmid: 20813282
references.citation: Vasc Med. 2006 Nov;11(3):201-11
references.pmid: 17288128
references.citation: Br J Clin Pharmacol. 2001 Jun;51(6):507-22
references.pmid: 11422010
references.citation: Am J Physiol. 1993 Jun;264(6 Pt 2):H1817-24
references.pmid: 8322910
references.citation: Exerc Sport Sci Rev. 1974;2:131-53
references.pmid: 4466663
references.citation: Am J Cardiol. 2001 Feb 15;87(4):413-9
references.pmid: 11179524
references.citation: Circulation. 2001 Oct 2;104(14):1694-740
references.pmid: 11581152
references.citation: Circulation. 2000 Oct 10;102(15):1788-94
references.pmid: 11023933
references.citation: Diabetes Res Clin Pract. 2010 Dec;90(3):326-32
references.pmid: 20926153
references.citation: J Am Soc Echocardiogr. 2004 Oct;17(10):1086-119
references.pmid: 15452478
references.citation: J Hypertens. 2004 Oct;22(10):1991-8
references.pmid: 15361772
references.citation: Am J Hypertens. 2005 Feb;18(2 Pt 1):191-6
references.pmid: 15752946
references.citation: J Am Coll Cardiol. 2010 Apr 27;55(17):1867-74
references.pmid: 20413039
references.citation: Am J Cardiol. 2004 Jan 1;93(1):40-4
references.pmid: 14697463
references.citation: Diabetes Care. 2001 Jan;24(1):5-10
references.pmid: 11194240
references.citation: Eur Heart J. 2007 Mar;28(5):553-9
references.pmid: 17311827
references.citation: J Appl Physiol (1985). 1999 Oct;87(4):1317-25
references.pmid: 10517758
references.citation: Circulation. 2008 Jul 22;118(4):346-54
references.pmid: 18606913
references.citation: J Am Coll Cardiol. 2004 Apr 21;43(8):1399-404
references.pmid: 15093874