Effects of the metabolic syndrome on right heart mechanics and function.
BACKGROUND
We sought to investigate right ventricular (RV) and right atrial (RA) deformation obtained using 3-dimensional echocardiography (3DE) and 2-dimensional (2DE) strain in subjects with the metabolic syndrome (MS).


METHODS
This cross-sectional study included 108 untreated subjects with the MS and 75 control subjects similar according to sex and age. The MS was defined by the presence ≥ 3 American Heart Association/National Heart, Lung, and Blood Institute criteria. All the subjects underwent adequate laboratory analyses and complete 2DE and 3DE examination.


RESULTS
2DE global longitudinal strain of the RV was significantly decreased in the MS group compared with the control subjects (-24 ± 5 vs -27 ± 5%; P < 0.001). Similar results were obtained for the RA longitudinal strain (40 ± 5 vs 44 ± 7%; P < 0.001). Systolic and early diastolic RV and RA strain rates were decreased, whereas late diastolic strain rates were increased among the MS participants compared with the control subjects. 3DE RV ejection fraction was significantly decreased in the MS subjects (55 ± 4 vs 58 ± 4%; P < 0.001). The multivariate analysis of MS criteria showed that systolic blood pressure, waist circumference, and fasting glucose were independently associated with RV and/or RA myocardial function and deformation.


CONCLUSIONS
RV mechanics and RA mechanics, assessed using 3DE and 2DE strain, were significantly deteriorated in the MS subjects. Among all MS risk factors, systolic blood pressure, abdominal circumference, and fasting glucose were the most responsible for the right heart remodelling.
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia. Electronic address: marijana_tadic@hotmail.com.
Marijana
M
Tadic
University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Meda, Italy.
Cesare
C
Cuspidi
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
Aleksandra
A
Sljivic
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
Anita
A
Andric
Clinical Centre of Serbia, Clinic of Cardiology, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia.
Branislava
B
Ivanovic
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia.
Radisav
R
Scepanovic
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
Irena
I
Ilic
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
Ljilja
L
Jozika
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia.
Tamara
T
Marjanovic
University Clinical Hospital Center "Dr Dragisa Misovic," Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia.
Vera
V
Celic
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D018450:Disease Progression; D019560:Echocardiography, Three-Dimensional; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016278:Ventricular Function, Right / Q000502:physiology*; D020257:Ventricular Remodeling
D001786:Blood Glucose