title: The impact of the metabolic syndrome on the outcome after aortic valve replacement.
abstract: OBJECTIVE
  The aim of this study was to examine the influence of the metabolic syndrome on the left ventricular geometry as well as on the early and mid-time outcome in patients with aortic stenosis who underwent aortic valve replacement.
  
  
  METHODS
  The study included 182 patients who underwent aortic valve replacement due to aortic stenosis. The metabolic syndrome was defined by the presence of at least three AHA-NHLB (American Heart Association/National Heart, Lung and Blood Institute) criteria. All the patients were followed for at least 2 years after the surgery.
  
  
  RESULTS
  The metabolic syndrome did not influence the severity of aortic stenosis (mean gradient and aortic valve area). However, the metabolic syndrome was associated with the reduced prevalence of the normal left ventricular geometry and the increased risk of concentric left ventricular hypertrophy in patients with aortic stenosis. Among the metabolic syndrome criteria, only increased blood pressure was simultaneously associated with the short-term and mid-term outcome, independently of other risk factors. Increased fasting glucose level was an independent predictor of the only 30-day outcome after the valve replacement. The metabolic syndrome and left ventricular hypertrophy were, independently of hypertension and diabetes, associated with the 30-day outcome, as well as incidence of major cerebrovascular and cardiovascular events in the 2-year postoperative period.
  
  
  CONCLUSIONS
  The metabolic syndrome does not change severity of the aortic stenosis, but significantly impacts the left ventricular remodeling in these patients. The metabolic syndrome and left ventricular hypertrophy, irrespective of hypertension and diabetes, are predictors of the short-term and mid-term outcome of patients with aortic stenosis who underwent aortic valve replacement.
authors.affiliation: aUniversity Clinical Hospital Center 'Dr Dragisa Misovic-Dedinje' bClinic of Cardiac Surgery cClinic of Cardiology, Clinical Center of Serbia dFaculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Marijana
authors.initials: M
authors.lastname: Tadic
authors.forename: Davor
authors.initials: D
authors.lastname: Vukadinovic
authors.forename: Dane
authors.initials: D
authors.lastname: Cvijanovic
authors.forename: Vera
authors.initials: V
authors.lastname: Celic
authors.forename: Mladen
authors.initials: M
authors.lastname: Kocica
authors.forename: Svetozar
authors.initials: S
authors.lastname: Putnik
authors.forename: Branislava
authors.initials: B
authors.lastname: Ivanovic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D017379:Hypertrophy, Left Ventricular / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D001786:Blood Glucose